Buchholz, Susan Weber; Ingram, Diana; Wilbur, JoEllen; Fogg, Louis; Sandi, Giselle; Moss, Angela; Ocampo, Edith V
Half of all adults in the United States do not meet the level of recommended aerobic physical activity. Physical activity interventions are now being conducted in the workplace. Accessible technology, in the form of widespread usage of cell phones and text messaging, is available for promoting physical activity. The purposes of this study, which was conducted in the workplace, were to determine (1) the feasibility of implementing a bilingual 12-week Text4Walking intervention and (2) the effect of the Text4Walking intervention on change in physical activity and health status in a food service employee population. Before conducting the study reported here, the Text4Walking research team developed a database of motivational physical activity text messages in English. Because Hispanic or Latino adults compose one-quarter of all adults employed in the food service industry, the Text4Walking team translated the physical activity text messages into Spanish. This pilot study was guided by the Physical Activity Health Promotion Framework and used a 1-group 12-week pre- and posttest design with food service employees who self-reported as being sedentary. The aim of the study was to increase the number of daily steps over the baseline by 3000 steps. Three physical activity text messages were delivered weekly. In addition, participants received 3 motivational calls during the study. SPSS version 19.0 and R 3.0 were used to perform the data analysis. There were 33 employees who participated in the study (57.6% female), with a mean age of 43.7 years (SD 8.4). The study included 11 Hispanic or Latino participants, 8 of whom requested that the study be delivered in Spanish. There was a 100% retention rate in the study. At baseline, the participants walked 102 (SD 138) minutes/day (per self-report). This rate increased significantly (P=.008) to 182 (SD 219) minutes/day over the course of the study. The participants had a baseline mean of 10,416 (SD 5097) steps, which also increased
Bowden, A. Brooks; Shand, Robert; Belfield, Clive R.; Wang, Anyi; Levin, Henry M.
Educational interventions are complex: Often they combine a diagnostic component (identifying student need) with a service component (ensuring appropriate educational resources are provided). This complexity raises challenges for program evaluation. These interventions, which we refer to as "service mediation interventions," affect…
Valentine, Daniel T
This study assessed outcomes in stuttering intervention across three service delivery models: direct, hybrid, and telepractice for two 11-year old children who stutter. The goal of the study was to investigate whether short-term goals were maintained through the telepractice sessions. The Stuttering Severity Instrument, Fourth Edition (SSI-4) was administered to each child before and after each intervention period and weekly fluency samples (percentage of stuttered syllables in a monologue) were obtained in each of the 10-week intervention periods. In addition, the Communication Attitudes Test-Revised was used to assess the children's attitudes toward speaking. Following the telepractice period, parents and children completed a questionnaire concerning the therapy experience via telepractice. Both children continued to improve fluency as measured by the weekly fluency samples. SSI-4 severity ratings improved for one child and remained consistent for the other. These outcomes appear to demonstrate that telepractice is viable for improving and maintaining fluency.
Daniel T. Valentine
Full Text Available This study assessed outcomes in stuttering intervention across three service delivery models: direct, hybrid, and telepractice for two 11-year old children who stutter. The goal of the study was to investigate whether short-term goals were maintained through the telepractice sessions. The Stuttering Severity Instrument, Fourth Edition (SSI-4 was administered to each child before and after each intervention period and weekly fluency samples (percentage of stuttered syllables in a monologue were obtained in each of the 10-week intervention periods. In addition, the Communication Attitudes Test-Revised was used to assess the children’s attitudes toward speaking. Following the telepractice period, parents and children completed a questionnaire concerning the therapy experience via telepractice. Both children continued to improve fluency as measured by the weekly fluency samples. SSI-4 severity ratings improved for one child and remained consistent for the other. These outcomes appear to demonstrate that telepractice is viable for improving and maintaining fluency.
Cassidy, Christine; Steenbeek, Audrey; Langille, Donald; Martin-Misener, Ruth; Curran, Janet
University students are at risk for acquiring sexually transmitted infections and suffering other negative health outcomes. Sexual health services offer preventive and treatment interventions that aim to reduce these infections and associated health consequences. However, university students often delay or avoid seeking sexual health services. An in-depth understanding of the factors that influence student use of sexual health services is needed to underpin effective sexual health interventions. In this study, we aim to design a behavior change intervention to address university undergraduate students' use of sexual health services at two universities in Nova Scotia, Canada. This mixed methods study consists of three phases that follow a systematic approach to intervention design outlined in the Behaviour Change Wheel. In Phase 1, we examine patterns of sexual health service use among university students in Nova Scotia, Canada, using an existing dataset. In Phase 2, we identify the perceived barriers and enablers to students' use of sexual health services. This will include focus groups with university undergraduate students, health care providers, and university administrators using a semistructured guide, informed by the Capability, Opportunity, Motivation-Behaviour Model and Theoretical Domains Framework. In Phase 3, we identify behavior change techniques and intervention components to develop a theory-based intervention to improve students' use of sexual health services. This study will be completed in March 2018. Results from each phase and the finalized intervention design will be reported in 2018. Previous intervention research to improve university students' use of sexual health services lacks a theoretical assessment of barriers. This study will employ a mixed methods research design to examine university students' use of sexual health service and apply behavior change theory to design a theory- and evidence-based sexual health service intervention. Our
Andersen, Ingelise; Borritz, Marianne; Christensen, Karl Bang
OBJECTIVE: In a longitudinal study design to analyze the development of burnout at worksites and to study the effect of interventions intended to reduce the level of burnout at individual level. METHODS: At baseline the study, sample consisted of 1024 individuals divided at six organizations and 18...... worksites in the human service sector. Four different types of interventions were identified: external and internal reorganizations, educational days, and consultancy. Burnout defined as work related, client related, and personal burnout was measured by means of the Copenhagen Burnout Inventory at baseline...... of interventions did not reduce the level of burnout in our study....
Full Text Available Objectives: Technological advances in healthcare have shown promise when delivering interventions for mental health problems such as psychosis. The aim of this project is to develop a mobile phone intervention for people with psychosis and to conduct a feasibility study of the TechCare App. Methods: The TechCare App will assess participant’s symptoms and respond with a personalised guided self-help-based psychological intervention with the aim of exploring feasibility and acceptability. The project will recruit 16 service users and 8–10 health professionals from the Lancashire Care NHS Foundation Trust Early Intervention Service. Results: In strand 1 of the study, we will invite people to discuss their experience of psychosis and give their opinions on the existing evidence-based treatment (cognitive behavioural therapy and how the mobile app can be developed. In strand 2, we will complete a test run with a small number of participants (n = 4 to refine the mobile intervention (TechCare. Finally, in strand 3 of the study, the TechCare App will be examined in a feasibility study with 12 participants. Conclusion: It has been suggested that there is a need for a rapid increase in the efforts to develop the evidence base for the clinical effectiveness of digital technologies, considering mHealth research can potentially be helpful in addressing the demand on mental health services globally.
Full Text Available Background: Immunization has been regarded as the most cost-effective intervention for child health promotion. Even after improvements, the developing countries are still struggling with low coverage rates, immunization failure, high rates of adverse events following immunization (AEFI etc. The present study was conducted to assess the role of educational intervention in improving immunization delivery services. Methodology: It was a pre-post intervention observational study carried out in immunization clinics of two tertiary care hospitals. The data from pre and post educational intervention assessment was compared and analyzed using SPSS 10.0. Results: At both clinics there was 40% and 45% increase in cleaning of the spoon used for administration of vitamin A. Post-intervention there was 40% increase in use of hub cutter at both the centres. After intervention, there was 30% and 35% increase in the delivery of four key messages by staff nurse. Conclusion: Unlike Doctors, the health staff is not motivated for regular touch with the theory part of their work field and continued knowledge up-gradation. This strategy of periodic re-orientation of the topic in the form of educational intervention may help in improving service delivery to the beneficiaries. Further research is required in this aspect.
Frazee-Brookman, Lauren; Stahmer, Aubyn; Stadnick, Nicole; Chlebowski, Colby; Herschel, Amy; Garland, Ann F.
This study characterized the use of research community partnerships (RCPs) to tailor evidence-based intervention, training, and implementation models for delivery across different childhood problems and service contexts using a survey completed by project principal investigators and community partners. To build on previous RCP research and to…
Meixner, Cara; O'Donoghue, Cynthia R; Witt, Michelle
To understand empirically the perceived barriers to accessing crisis intervention services for individuals with acquired brain injury. This action research design encompassed two phases of mixed methods data collection and analysis. Phase one consisted of the electronic distribution of a survey comprised primarily of quantitative items, launched to a nonrandom sample of 226 providers with a response rate of 49% (n = 110). Phase two entailed seven focus group interviews with 25 participants, designed to add explanatory power to phase one results. Quantitative results revealed an array of major barriers significant to persons with brain injury, such as funding for services, coexisting diagnoses, and limited self-advocacy. Organizationally specific barriers included funding for services, limited training and education, and systems resources (e.g., personnel). Adding depth and insight, qualitative findings triangulated with these results, also highlighting the prevalence of the funding barrier and pointing to additional barriers relative to the individual, the family, and external stigma. The need for convenient, cost-effective, and applicable training and education is paramount. Opportunities for interagency cross training and education, particularly around risk assessment, psychosocial adjustment symptoms, and the biomechanical causes of psychiatric symptoms may alleviate perceived disconnections, improve provider confidence, and mitigate crises. Developing interprofessional teams of providers to maximize access to services, either face-to-face or virtual, is integral. These perspectives highlight opportunities to improve access to services and to strengthen relationships across providers and agencies. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Willging, Cathleen E; Aarons, Gregory A; Trott, Elise M; Green, Amy E; Finn, Natalie; Ehrhart, Mark G; Hecht, Debra B
Sustainment of evidence-based interventions (EBIs) in human services depends on the inner context of community-based organizations (CBOs) that provide services and the outer context of their broader environment. Increasingly, public officials are experimenting with contracting models from for-profit industries to procure human services. In this case study, we conducted qualitative interviews with key government and CBO stakeholders to examine implementation of the Best Value-Performance Information Procurement System to contract for EBIs in a child welfare system. Findings suggest that stakeholder relationships may be compromised when procurement disregards local knowledge, communication, collaboration, and other factors supporting EBIs and public health initiatives.
Chiu, Teresa M L; Eysenbach, Gunther
The purpose of this qualitative study was to improve understanding of family caregivers' use of Web-based intervention support by integrating three theoretical models. The study applied the Anderson's model of health service utilization, Venkatesh's theory of technology acceptance, and Chatman's and Wilson's information behavior theories. This qualitative study is part of a larger study. An interpretive grounded theory approach was used to conduct in-depth interviews with Chinese caregivers of family members with dementia. The caregivers received Internet-based information support and personalized e-mail intervention. A purposive sample of fourteen caregivers was selected to participate in the interviews. Constant comparison, analytic memoing, case analysis, and concept mapping were used to conduct theoretical triangulation analysis. Three main factors influenced the use of the intervention: (a) caregiver needs, which are influenced by personal capacity, social support available, and caregiving belief; (b) information communication technology (ICT) factors, including accessibility barriers and perceived efforts to use the technology; and (c) style of using the technology, such as preference for using e-mail or the customized Website. The personal capacity of caregivers was influenced by many factors, including computer and language proficiency, health service knowledge, caregiving competence and competing roles and responsibilities. Social support available for caregivers included available computer, language or caregiving support and health service knowledge. Caregiving belief included traditional belief of giving care, and health belief of the illness. New caregivers needed a different kind of support intervention compared with experienced caregivers. Caregivers with different amounts of experience tended to have different learning styles, with new caregivers preferring interactive intervention and more experienced caregivers preferring more reflective learning
Osilla, Karen Chan; Pedersen, Eric R; Gore, Kristie; Trail, Thomas; Howard, Stefanie Stern
Alcohol misuse among military service members from the recent conflicts in Iraq and Afghanistan is over two times higher compared to misuse in the civilian population. Unfortunately, in addition to experiencing personal consequences from alcohol misuse, partners and family members of alcohol-misusing service members also suffer in negative ways from their loved one's drinking. These family members represent important catalysts for helping their loved ones identify problem drinking and overcoming the barriers to seeking care. This paper describes the protocol to a pilot study evaluating a 4-session, web-based intervention (WBI) for concerned partners (CPs) of service members with alcohol misuse. The WBI will be adapted from the Community Reinforcement and Family Training (CRAFT) intervention. In the first phase, we will develop and beta-test the WBI with 15-20 CPs. In the second phase, we will randomize CPs to WBI (n = 50) or to delayed-WBI (n = 50) and evaluate the impact of the WBI on CPs' perceptions of service member help-seeking and drinking, as well as the CP's well-being and relationship satisfaction 3 months after the intervention. In the third phase, we will recruit 15-20 service members whose partners have completed the study. We will interview the service members to learn how the CP-focused WBI affected them and to assess whether they would be receptive to a follow-on WBI module to help them. This project has the potential to benefit a large population of military service members who may be disproportionately affected by recent conflicts and whose drinking misuse would otherwise go undetected and untreated. It also develops a new prevention model that does not rely on service members or partners attending a hospital or clinical facility to access care. NCT02073825.
Viator, Catherine; Blitstein, Jonathan; Brophy, Jenna E; Fraser, Angela
This study reviews the current literature on behavioral and environmental food safety interventions conducted in commercial and institutional food service settings. A systematic search of the published literature yielded 268 candidate articles, from which a set of 23 articles reporting intervention outcomes was retained for evaluation. A categorization of measured outcomes is reported; studies addressed multiple outcomes ranging from knowledge, attitudes, and behavior of personal hygiene and food safety to management practices and disease rates and outbreaks. This study also investigates the quality of reported research methods used to evaluate the effectiveness of the interventions, using a nine-point quality index adapted by the authors. The observed scores suggest that there are opportunities to improve the design and reporting of research in the field of foodborne disease prevention as it applies to food safety interventions that target the food service industry. The aim is to aid researchers in this area to design higher quality studies and to produce clearer and more useful reports of their research. In turn, this can help to create a more complete evidence base that can be used to continually improve interventions in this domain.
Phillips, Jane L; Rolley, John X; Davidson, Patricia M
Aims and Objectives. This paper provides an overview of the applicability of the PRECEDE-PROCEED Model to the development of targeted nursing led chronic illness interventions. Background. Changing health care practice is a complex and dynamic process that requires consideration of social, political, economic, and organisational factors. An understanding of the characteristics of the target population, health professionals, and organizations plus identification of the determinants for change are also required. Synthesizing this data to guide the development of an effective intervention is a challenging process. The PRECEDE-PROCEED Model has been used in global health care settings to guide the identification, planning, implementation, and evaluation of various health improvement initiatives. Design. Using a reflective case study approach, this paper examines the applicability of the PRECEDE-PROCEED Model to the development of targeted chronic care improvement interventions for two distinct Australian populations: a rapidly expanding and aging rural population with unmet palliative care needs and a disadvantaged urban community at higher risk of cardiovascular disease. Results. The PRECEDE-PROCEED Model approach demonstrated utility across diverse health settings in a systematic planning process. In environments characterized by increasing health care needs, limited resources, and growing community expectations, adopting planning tools such as PRECEDE-PROCEED Model at a local level can facilitate the development of the most effective interventions. Relevance to Clinical Practice. The PRECEDE-PROCEED Model is a strong theoretical model that guides the development of realistic nursing led interventions with the best chance of being successful in existing health care environments.
Jane L. Phillips
Full Text Available Aims and Objectives. This paper provides an overview of the applicability of the PRECEDE-PROCEED Model to the development of targeted nursing led chronic illness interventions. Background. Changing health care practice is a complex and dynamic process that requires consideration of social, political, economic, and organisational factors. An understanding of the characteristics of the target population, health professionals, and organizations plus identification of the determinants for change are also required. Synthesizing this data to guide the development of an effective intervention is a challenging process. The PRECEDE-PROCEED Model has been used in global health care settings to guide the identification, planning, implementation, and evaluation of various health improvement initiatives. Design. Using a reflective case study approach, this paper examines the applicability of the PRECEDE-PROCEED Model to the development of targeted chronic care improvement interventions for two distinct Australian populations: a rapidly expanding and aging rural population with unmet palliative care needs and a disadvantaged urban community at higher risk of cardiovascular disease. Results. The PRECEDE-PROCEED Model approach demonstrated utility across diverse health settings in a systematic planning process. In environments characterized by increasing health care needs, limited resources, and growing community expectations, adopting planning tools such as PRECEDE-PROCEED Model at a local level can facilitate the development of the most effective interventions. Relevance to Clinical Practice. The PRECEDE-PROCEED Model is a strong theoretical model that guides the development of realistic nursing led interventions with the best chance of being successful in existing health care environments.
Full Text Available Abstract Background Health clinicians perceive certain patients as 'difficult' across all settings, including mental health care. In this area, patients with non-psychotic disorders that become long-term care users may be perceived as obstructing their own recovery or seeking secondary gain. This negative perception of patients results in ineffective responses and low-quality care by health clinicians. Using the concept of illness behaviour, this paper describes the development, implementation, and planned evaluation of a structured intervention aimed at prevention and management of ineffective behaviours by long-term non-psychotic patients and their treating clinicians. Methods The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the intervention. Qualitative (individual and group interviews, quantitative (survey, and mixed methods (Delphi-procedure research was used to gain a broad perspective of the problem. Empirical findings, theoretical models, and existing evidence were combined to construct a program tailored to the needs of the target groups. Results A structured program to increase effective illness behaviour in long-term non-psychotic patients and effective professional behaviour in their treating clinicians was developed, consisting of three subsequent stages and four substantial components, that is described in detail. Implementation took place and evaluation of the intervention is being carried out. Conclusions Intervention Mapping proved to be a suitable method to develop a structured intervention for a multi-faceted problem in mental health care.
Koekkoek, Bauke; van Meijel, Berno; Schene, Aart; Hutschemaekers, Giel
Health clinicians perceive certain patients as 'difficult' across all settings, including mental health care. In this area, patients with non-psychotic disorders that become long-term care users may be perceived as obstructing their own recovery or seeking secondary gain. This negative perception of patients results in ineffective responses and low-quality care by health clinicians. Using the concept of illness behaviour, this paper describes the development, implementation, and planned evaluation of a structured intervention aimed at prevention and management of ineffective behaviours by long-term non-psychotic patients and their treating clinicians. The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the intervention. Qualitative (individual and group interviews), quantitative (survey), and mixed methods (Delphi-procedure) research was used to gain a broad perspective of the problem. Empirical findings, theoretical models, and existing evidence were combined to construct a program tailored to the needs of the target groups. A structured program to increase effective illness behaviour in long-term non-psychotic patients and effective professional behaviour in their treating clinicians was developed, consisting of three subsequent stages and four substantial components, that is described in detail. Implementation took place and evaluation of the intervention is being carried out. Intervention Mapping proved to be a suitable method to develop a structured intervention for a multi-faceted problem in mental health care.
Chronister, Julie; Chou, Chih-Chin; da Silva Cardoso, Elizabeth; Sasson, Joy; Chan, Fong; Tan, Soo Yin
This study examined factors influencing employment outcomes of people with substance-related disorders (SRDs) in state vocational rehabilitation (VR) agencies. The sample included 34,774 VR clients with SRDs from fiscal year 2001. Mean age of participants was 38.35 years. Predictor variables included personal and service variables and the…
Csillag, Claudio; Nordentoft, Merete; Mizuno, Masafumi
AIM: Early intervention (EI) in psychosis is a comprehensive and evidence-based approach aimed at detection and treatment of psychotic symptoms in their early stages. This paper presents core features and noteworthy aspects of the evidence basis and limitations of EI, the importance of programme ....... Wider dissemination of EI services will probably benefit from better integration of potential funders, promotion of joint targets and shared financial or budgetary incentives....... overcome these difficulties. CONCLUSIONS: Funding for mental health in general and for EI services appears low relative to need. One key argument for better funding for EI can be found in its favourable cost-effectiveness, but not all stakeholders beyond mental health administrators are aware of this...
Thomas, Kristin; Bendtsen, Marcus; Linderoth, Catharina; Karlsson, Nadine; Bendtsen, Preben; Müssener, Ulrika
Despite significant health risks, heavy drinking of alcohol among university students is a widespread problem; excessive drinking is part of the social norm. A growing number of studies indicate that short message service (SMS)-based interventions are cost-effective, accessible, require limited effort by users, and can enable continuous, real-time, brief support in real-world settings. Although there is emerging evidence for the effect of SMS-based interventions in reducing alcohol consumption, more research is needed. This study aims to test the effectiveness of a newly developed SMS-based intervention targeting excessive alcohol consumption among university and college students in Sweden. The study is a two-arm randomized controlled trial with an intervention (SMS programme) and a control (treatment as usual) group. Outcome measures will be investigated at baseline and at 3-month follow up. The primary outcome is total weekly alcohol consumption. Secondary outcomes are frequency of heavy episodic drinking, highest estimated blood alcohol concentration and number of negative consequences due to excessive drinking. This study contributes knowledge on the effect of automatized SMS support to reduce excessive drinking among students compared with existing support such as Student Health Centres. ISRCTN.com, ISRCTN95054707 . Registered on 31 August 2016.
Baucom, Donald H; Fischer, Melanie S; Worrell, Michael; Corrie, Sarah; Belus, Jennifer M; Molyva, Efthymia; Boeding, Sara E
This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple-based treatment for depression (BCT-D) provided in London services that are part of the "Improving Access to Psychological Therapies" (IAPT) program in England. Twenty-three therapists in community clinics were trained in BCT-D during a 5-day workshop, followed by monthly group supervision for 1 year. The BCT-D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT-D. Eighty-five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT-D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT-D, although they were not the focus of treatment. BCT-D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT-D in routine clinical settings. © 2017 Family Process Institute.
Kondo, Naoki; Ishikawa, Yoshiki
Socioeconomically vulnerable people are likely to have more health risks because of inadequate behaviour choices related to chronic social stresses. Brain science suggests that stress causes cognitively biased automatic decision making, preferring instant stress relief and pleasure (eg, smoking, alcohol use and drug abuse) as opposed to reflectively seeking health-maintenance services (eg, health check-ups). As such, hedonic stimuli that nudge people towards preventive actions could reduce health behaviour disparities. The purpose of this intervention study was to test this hypothesis. An instant health check-up service company had 320 health check-up sessions at pachinko (Japanese gambling) parlours; 1721 persons in intervention sessions and 6507 persons in control sessions received the service. The stimuli the company used in the intervention sessions were young women wearing mildly erotic nurse costumes, who solicited the pachinko players for health check-up services. We compared the prevalence of socioeconomically vulnerable individuals between the intervention and control sessions, adjusting for individual-level and parlour-level potential confounders. Even adjusting for health risks and within-parlour clustering, the intervention sessions gathered more socioeconomically vulnerable customers than the regular sessions. Compared with control sessions, in intervention sessions the adjusted prevalence ratios were 1.15 (95% CI 0.99 to 1.35) for not having a job (vs having a job) and 1.36 (95% CI 1.00 to 1.86) for holders of National Health Insurance (which includes more socially vulnerable people than other insurance programmes). The results supported our hypothesis. Offering health check-up opportunities equipped with 'tricks' that nudge people to act might be effective for anyone but is potentially more valuable for socially vulnerable people. Ethical discussions are needed to further consider the use of erotic stimuli and other essential drivers of human
Casteel, Carri; Peek-Asa, Corinne; Greenland, Sander; Chu, Lawrence D; Kraus, Jess F
Examine the effectiveness of a robbery and violence prevention program in small businesses in Los Angeles. Gas/convenience, liquor and grocery stores, bars/restaurants, and motels were enrolled between 1997 and 2000. Intervention businesses (n = 305) were provided training, program implementation materials, and recommendations for a comprehensive security program. Control businesses (n = 96) received neither training nor program materials. Rate ratios comparing intervention to control businesses were 0.90 for violent crime (95% confidence limits [CL] = 0.53, 1.53) and 0.81 for robbery (95% CL = 0.38, 1.73). The reduction in violent crime was concentrated in high-compliance intervention businesses (risk ratio = 0.74, 95% CL = 0.40, 1.36). Low-compliance intervention businesses had practically the same postintervention crime as the control businesses. Our results suggest that the workplace violence intervention may reduce violent crime among high-risk businesses, especially those with high program compliance.
Bryant, Jamie; Bonevski, Billie; Paul, Christine; O'Brien, Jon; Oakes, Wendy
.... This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appropriate to the social and community service setting...
Knowles, Sarah; Planner, Claire; Bradshaw, Tim; Peckham, Emily; Man, Mei-See; Gilbody, Simon
Smoking is one of the major modifiable risk factors contributing to early mortality for people with serious mental illness. However, only a minority of service users access smoking cessation interventions and there are concerns about the appropriateness of generic stop-smoking services for this group. The SCIMITAR (Smoking Cessation Intervention for Severe Mental Ill-Health Trial) feasibility study explored the effectiveness of a bespoke smoking cessation intervention delivered by mental health workers. This paper reports on the nested qualitative study within the trial. Qualitative semi-structured interviews were conducted with 13 service users receiving the intervention and 3 of the MHSCPs (mental health smoking cessation practitioners) delivering the intervention. Topic guides explored the perceived acceptability of the intervention particularly in contrast to generic stop-smoking services, and perceptions of the implementation of the intervention in practice. Transcripts were analysed using the Constant Comparative Method. Generic services were reported to be inappropriate for this group, due to concerns over stigma and a lack of support from health professionals. The bespoke intervention was perceived positively, with both practitioners and service users emphasising the benefits of flexibility and personalisation in delivery. The mental health background of the practitioners was considered valuable not only due to their increased understanding of the service users' illness but also due to the more collaborative relationship style they employed. Challenges involved delays in liaising with general practitioners and patient struggles with organisation and motivation, however the MHSCP was considered to be well placed to address these problems. The bespoke smoking cessation intervention was acceptable to service users and the both service users and practitioners reported the value of a protected mental health worker role for delivering smoking cessation to this
Full Text Available Abstract Background Young children are not participating in recommended levels of physical activity and exhibit high levels of sedentary behaviour. Childcare services provide access to large numbers of young children for prolonged periods, yet there is limited experimental evidence regarding the effectiveness of physical activity interventions implemented in this setting. The aim of this study is to assess the effectiveness and acceptability of a multi-component physical activity intervention, delivered by childcare service staff, in increasing the physical activity levels of children attending long day care services. Methods/Design The study will employ a cluster randomised controlled trial design. Three hundred children aged between 3-5 years from twenty randomly selected long day care services in the Hunter Region of New South Wales, Australia will be invited to participate in the trial. Ten of the 20 long day care services will be randomly allocated to deliver the intervention with the remaining ten services allocated to a wait list control group. The physical activity intervention will consist of a number of strategies including: delivering structured fundamental movement skill activities, increasing physical activity opportunities, increasing staff role modelling, providing children with a physical activity promoting indoor and outdoor environment and limiting children's small screen recreation and sedentary behaviours. Intervention effectiveness will be measured via child physical activity levels during attendance at long day care. The study also seeks to determine the acceptability and extent of implementation of the intervention by services and their staff participating in the study. Discussion The trial will address current gaps in the research evidence base and contribute to the design and delivery of future interventions promoting physical activity for young children in long day care settings. Trial registration Australian New
Full Text Available Early Intervention (EI services for children birth through two years of age are mandated by Part C of the Individuals with Disabilities Education Act (IDEA; however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telerehabilitation has the potential to build capacity among caregivers and local providers as well as promote family-centered services through remote consultation. This article provides an overview of research related to telerehabilitation and early intervention services; discusses the feasibility of telerehabilitation within traditional EI service delivery models; examines telecommunications technology associated with telerehabilitation; and provides hypothetical case examples designed to illustrate potential applications of telerehabilitation in early intervention.
Early Intervention (EI) services for children birth through two years of age are mandated by Part C of the Individuals with Disabilities Education Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telerehabilitation has the potential to build capacity among caregivers and local providers as well as promote family-centered services through remote consultation. This article provides an overview of research related to telerehabilitation and early intervention services; discusses the feasibility of telerehabilitation within traditional EI service delivery models; examines telecommunications technology associated with telerehabilitation; and provides hypothetical case examples designed to illustrate potential applications of telerehabilitation in early intervention.
Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie
In November 2015, WHO released new treatment guidelines recommending that all diagnosed as HIV positive be enrolled on antiretroviral therapy (ART). Sustaining and expanding ART scale-up programs in resource-limited settings will require adaptations and modifications to traditional ART delivery models to meet the rapid increase in demand. We identify modifications to ART service delivery models by health facilities in Uganda to sustain ART interventions over a 10-year period (2004-2014). A mixed methods approach involving two study phases was adopted. In the first phase, a survey of a nationally representative sample of health facilities (n = 195) in Uganda which were accredited to provide ART between 2004 and 2009 was conducted. The second phase involved semi-structured interviews (n = 18) with ART clinic managers of 6 of the 195 health facilities purposively selected from the first study phase. We adopted a thematic framework consisting of four categories of modifications (format, setting, personnel, and population). The majority of health facilities 185 (95%) reported making modifications to ART interventions between 2004 and 2014. Of the 195 health facilities, 157 (81%) rated the modifications made to ART as "major." Modifications to ART were reported under all the four themes. The quantitative and qualitative findings are integrated and presented under four themes. Format: Reducing the frequency of clinic appointments and pharmacy-only refill programs was identified as important strategies for decongesting ART clinics. Home-based care programs were introduced to reduce provider ART delivery costs. Personnel: Task shifting to non-physician cadre was reported in 181 (93%) of the health facilities. Visits to the ART clinic were rationalized in favor of the sub-population deemed to have more clinical need. Two health facilities focused on patients living nearer the health facilities to align with targets set by external donors. Over the study period
Seward, Kirsty; Wolfenden, Luke; Finch, Meghan; Wiggers, John; Wyse, Rebecca; Jones, Jannah; Gillham, Karen; Yoong, Sze Lin
Interventions to improve child diet are recommended as dietary patterns developed in childhood track into adulthood and influence the risk of chronic disease. For child health, childcare services are required to provide foods to children consistent with nutrition guidelines. Research suggests that foods and beverages provided by services to children are often inconsistent with nutrition guidelines. The primary aim of this study is to assess, relative to a usual care control group, the effectiveness of a multistrategy childcare-based intervention in improving compliance with nutrition guidelines in long day care services. The study will employ a parallel group randomised controlled trial design. A sample of 58 long day care services that provide all meals (typically includes 1 main and 2 mid-meals) to children while they are in care, in the Hunter New England region of New South Wales, Australia, will be randomly allocated to a 6-month intervention to support implementation of nutrition guidelines or a usual care control group in a 1:1 ratio. The intervention was designed to overcome barriers to the implementation of nutrition guidelines assessed using the theoretical domains framework. Intervention strategies will include the provision of staff training and resources, audit and feedback, ongoing support and securing executive support. The primary outcome of the trial will be the change in the proportion of long day care services that have a 2-week menu compliant with childcare nutrition guidelines, measured by comprehensive menu assessments. As a secondary outcome, child dietary intake while in care will also be assessed. To assess the effectiveness of the intervention, the measures will be undertaken at baseline and ∼6 months postbaseline. The study was approved by the Hunter New England Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications. Published by the BMJ Publishing Group Limited. For permission
Dembo, Richard; Wareham, Jennifer; Poythress, Norman G.; Cook, Brittany; Schmeidler, James
We report the impact of case management services and youth psychopathy on Juvenile Diversion program completion for youths involved in a clinical trial, and evaluation of an innovative intervention service providing 16 weeks of intensive case management services to youths and their families. The present study examines baseline interview data for…
Todd, Nicholas J; Jones, Steven H; Lobban, Fiona A
Bipolar disorder (BD) is a chronic and recurrent severe mental health problem. A web-based self-management intervention provides the opportunity to widen access to psychological interventions. This qualitative study aims to identify what an ideal web-based intervention would look like for service users with BD. Twelve service users with BD were recruited in the UK and took part in a series of focus groups to inform and refine the development of a web-based self-management intervention. Reported here is a subset analysis of data gathered with the primary aim of identifying the needs and desires of service users for such an intervention for BD. We analysed service users' responses to questions about content, outcomes, format, barriers and support. Focus groups were transcribed verbatim, and thematic analysis was employed. The data were ordered into four key themes: (1) gaining an awareness of and managing mood swings; (2) not just about managing mood swings: the importance of practical and interpersonal issues; (3) managing living within mood swings without losing the experience; (4) internet is the only format: freely accessible, instant and interactive; (5) professional and peer support to overcome low motivation and procrastination difficulties. The small group of participants are not representative of those living with BD. These findings have significantly enhanced our understanding of what service users with BD want from a web-based self-management intervention and have clear implications for the future development of such approaches. Service users desire a web-based self-management approach that gives them the techniques they need to not only manage their moods but also manage their lives alongside the disorder, including interpersonal and practical issues. Service users describe their primary outcome, not as a cure or reduction in their symptoms, but instead being able to live a fulfilling life alongside their condition. Service users see the internet as their
Seward, Kirsty; Finch, Meghan; Wiggers, John; Wyse, Rebecca; Jones, Jannah; Gillham, Karen; Yoong, Sze Lin
Introduction Interventions to improve child diet are recommended as dietary patterns developed in childhood track into adulthood and influence the risk of chronic disease. For child health, childcare services are required to provide foods to children consistent with nutrition guidelines. Research suggests that foods and beverages provided by services to children are often inconsistent with nutrition guidelines. The primary aim of this study is to assess, relative to a usual care control group, the effectiveness of a multistrategy childcare-based intervention in improving compliance with nutrition guidelines in long day care services. Methods and analysis The study will employ a parallel group randomised controlled trial design. A sample of 58 long day care services that provide all meals (typically includes 1 main and 2 mid-meals) to children while they are in care, in the Hunter New England region of New South Wales, Australia, will be randomly allocated to a 6-month intervention to support implementation of nutrition guidelines or a usual care control group in a 1:1 ratio. The intervention was designed to overcome barriers to the implementation of nutrition guidelines assessed using the theoretical domains framework. Intervention strategies will include the provision of staff training and resources, audit and feedback, ongoing support and securing executive support. The primary outcome of the trial will be the change in the proportion of long day care services that have a 2-week menu compliant with childcare nutrition guidelines, measured by comprehensive menu assessments. As a secondary outcome, child dietary intake while in care will also be assessed. To assess the effectiveness of the intervention, the measures will be undertaken at baseline and ∼6 months postbaseline. Ethics and dissemination The study was approved by the Hunter New England Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications. PMID
Dupree, Jeffrey J.; Morote, Elsa Sofia
This study examines differences, if any, between gender, level of motivation, and students' classification (typical learners, academic intervention services learners, and gifted) in scores upon DBQ (document-based questions) among the sixth grade students. 64 grade students were given a DBQ as part of their final examination. Students' scores were…
van Roosmalen, Marc; Gardner-Elahi, Catherine; Day, Crispin
Over the last 15 years, policy initiatives have aimed at the provision of more comprehensive Child and Adolescent Mental Health care. These presented a series of new challenges in organising and delivering Tier 2 child mental health services, particularly in schools. This exploratory study aimed to examine and clarify the service model underpinning a Tier 2 child mental health service offering school-based mental health work. Using semi-structured interviews, clinician descriptions of operational experiences were gathered. These were analysed using grounded theory methods. Analysis was validated by respondents at two stages. A pathway for casework emerged that included a systemic consultative function, as part of an overall three-function service model, which required: (1) activity as a member of the multi-agency system; (2) activity to improve the system working around a particular child; and (3) activity to universally develop a Tier 1 workforce confident in supporting children at risk of or experiencing mental health problems. The study challenged the perception of such a service serving solely a Tier 2 function, the requisite workforce to deliver the service model, and could give service providers a rationale for negotiating service models that include an explicit focus on improving the children's environments.
Nylén, Eva Charlotta; Lindfors, Petra; Ishäll, Lars; Göransson, Sara; Aronsson, Gunnar; Kylin, Camilla; Sverke, Magnus
Psychosocial factors, including job demands and poor resources, have been linked to stress, health problems, and negative job attitudes. However, worksite based interventions and programs targeting psychosocial factors may change employees' perceptions of their work climate and work attitudes. This pilot study describes a newly developed worksite based participatory organizational intervention program that was tested in the social service sector. It is evaluated using participants' perceptions of the intervention to investigate its acceptability as a feature of feasibility and its short-term effects on work climate factors (job demands and resources) and work-related attitudes. Forty employees of a Swedish social service unit provided self-reports before, during, and after the intervention. As for effects, quantitative role overload and social support decreased while turnover intention increased. Responses to an open-ended question showed that participants considered the intervention program valuable for addressing issues relating to the psychosocial work climate. Although the findings are preliminary, it was possible to carry out this worksite based participatory organizational program in this particular setting. Also, the preliminary findings underscore the challenges associated with designing and implementing this type of intervention program, thus adding to the methodological discussion on implementation and evaluation.
Bölenius, Karin; Lämås, Kristina; Sandman, Per-Olof; Edvardsson, David
The literature indicates that current home care service are largely task oriented with limited focus on the involvement of the older people themselves, and studies show that lack of involvement might reduce older people's quality of life. Person-centred care has been shown to improve the satisfaction with care and quality of life in older people cared for in hospitals and nursing homes, with limited published evidence about the effects and meanings of person-centred interventions in home care services for older people. This study protocol outlines a study aiming to evaluate such effects and meanings of a person-centred and health-promoting intervention in home aged care services. The study will take the form of a non-randomised controlled trial with a before/after approach. It will include 270 older people >65 years receiving home care services, 270 relatives and 65 staff, as well as a matched control group of equal size. All participants will be recruited from a municipality in northern Sweden. The intervention is based on the theoretical concepts of person-centredness and health-promotion, and builds on the four pedagogical phases of: theory apprehension, experimental learning, operationalization, and clinical supervision. Outcome assessments will focus on: a) health and quality of life (primary outcomes), thriving and satisfaction with care for older people; b) caregiver strain, informal caregiving engagement and relatives' satisfaction with care: c) job satisfaction and stress of conscience among care staff (secondary outcomes). Evaluation will be conducted by means of self-reported questionnaires and qualitative research interviews. Person-centred home care services have the potential to improve the recurrently reported sub-standard experiences of home care services, and the results can point the way to establishing a more person-centred and health-promoting model for home care services for older people. NCT02846246 .
Hackett, Katie L; Newton, Julia L; Deane, Katherine H O; Rapley, Tim; Deary, Vincent; Kolehmainen, Niina; Lendrem, Dennis; Ng, Wan-Fai
A significant proportion of patients with primary Sjögren's syndrome (PSS) is functionally impaired and experience difficulties participating in various aspects of everyday life. There is currently no evidence of efficacy for non-pharmacological interventions aimed specifically at supporting the patients with PSS to improve their participation and ability to perform daily activities. This paper describes a research protocol for a mixed-methods study to develop an intervention to improve these outcomes. The protocol follows the Medical Research Council framework for complex interventions. We will use group concept mapping with the patients, adults who live with them and healthcare professionals to identify factors which prevent people with PSS from participating in daily life and performing daily activities. The factors will be prioritised by participants for importance and feasibility and will inform an intervention to be delivered within a National Health Service (NHS) setting. Evidence-based intervention techniques will be identified for the prioritised factors and combined into a deliverable intervention package. Key stakeholders will comment on the intervention content and mode of delivery through focus groups, and the data will be used to refine the intervention. The acceptability and feasibility of the refined intervention will be evaluated in a future study. The study has been approved by an NHS Research Ethics Committee, REC Reference: 13/NI/0190. The findings of this study will be disseminated in peer-reviewed journals and through presentation at national and international conferences. UKCRN Study ID: 15939. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Early Intervention (EI) services for children birth through two years of age are mandated by Part C of the Individuals with Disabilities Education Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telerehabilitation has the potential to build capacity among caregivers and local providers as well as promote family-centered services through remote consultation. This article provides an overview of research related to telerehabili...
Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad
Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (PService quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.
In this case study we examine the raison d'être and implementation of a policy intervention, which was promulgated in 2005 for the purpose of eradicating inefficiency and corruption, and inculcating customer orientation in the Nigerian public sector. The policy goes by the acronym 'SERVICOM' -'service compact with all ...
Ziviani, Jenny; Darlington, Yvonne; Feeney, Rachel; Rodger, Sylvia; Watter, Pauline
Early intervention (EI) for children with physical disabilities is advocated as a means of enhancing child outcomes and family functioning. The issues confronted by service providers in delivering this support have received relatively little attention. The purpose of this study was to gain an understanding of the experiences of frontline EI staff…
Strömbäck, Maria; Malmgren-Olsson, Eva-Britt; Wiklund, Maria
.... This qualitative study aims to illuminate young women's experiences of participating in a body-based, gender-sensitive stress management group intervention by youth-friendly health services in northern Sweden...
Full Text Available Francesca D Reeder,1 Nusrat Husain,2 Abdul Rhouma,3 Peter M Haddad,2 Tariq Munshi,4 Farooq Naeem,4 Davit Khachatryan,4 Imran B Chaudhry2 1School of Medicine, 2Neurosciences and Psychiatry Unit, University of Manchester, Manchester, 3Early Intervention Service, Lancashire Care NHS Foundation Trust, Preston, UK; 4Queen’s University, Kingston, Ontario, Canada Aim: There is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review.Methods: This is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis.Results: The mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample. Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%, parental mental illness (19%, bullying (18%, absence of a parent (13%, and ‘other’ trauma (24% – the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma.Conclusion: A high prevalence of childhood trauma (particularly trauma related to the home environment or family unit was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with
Gallagher, Jen; Schlösser, Annette
Ten per cent of young people experience mental health difficulties at any one time. Prevention and early intervention leads to better prognosis for young people's mental well-being in the short and long term. Child and Adolescent Mental Health Services (CAMHS) must be able to provide swift and effective interventions for a range of difficulties to…
Bohanna, India; Bird, Katrina; Copeland, Jan; Roberts, Nicholas; Clough, Alan
Regular cannabis use is associated with negative mental health impacts including psychosis, depression and anxiety. Rates of cannabis use have increased in Aboriginal and Torres Strait Islander communities in northern Australia within the last two decades, presenting a significant increased risk to young people's mental health in these regions. Improved screening, early detection and treatment for cannabis-related mental health issues are urgently required. This paper describes a service-level action research intervention and evaluation protocol for use in the few services where it is possible to engage young Aboriginal and Torres Strait Islander Australians. The protocol is being developed in two services where youth mental health is core business: a primary healthcare centre and a youth service in the Cairns and hinterland region, far north Queensland. The protocol calls first for baseline data to be collected using staff and client surveys; network mapping; and analysis of screening, treatment and referral rates. The protocol's intervention phase is driven by service needs identified from baseline data. Intervention strategies focus on implementing/enhancing cannabis screening instruments and processes in line with current best practice; enhancing networks with external drug and mental health services; developing culturally acceptable training and resources; developing activities aiming to reduce cannabis use in young Aboriginal and Torres Strait Islander clients using the services. The protocol requires implementation of the multilevel intervention within each service for 1 year, with follow-up data then collected and compared to baseline. Process evaluation identifies the more effective intervention strategies and documents the challenges to be overcome for full implementation. Ethics approval was provided by The James Cook University, Human Research Ethics Committee. Ethics Approval Number H5322. Peer-reviewed publications will also be used to disseminate
Poythress, Norman G.; Dembo, Richard; DuDell, Gary; Wareham, Jennifer
In this issue we describe a clinical trials study of the impact of adding specific case manager overlay services to "treatment as usual" services for youths in a Juvenile Arbitration Program. In this first article we describe the experimental intervention, the Arbitration Intervention Worker (AIW) service, which was provided to a randomly selected…
Mattern, Janet A.
Participation in high quality early intervention programs is critical for eligible young children who experience atypical development for their future academic success. High quality programs promote access to services, incorporate instructional strategies that encourage children's participation, and advocate public policy that supports…
Spector, Anya Y.; Pinto, Rogério M.
Health and social service practitioners have not readily incorporated research-based behavioral interventions in HIV prevention practice due to lack of awareness, lack of training, and challenges translating research findings into practice. Practitioners' involvement in research is associated with their willingness to use research to guide…
Langan, Charles J.
The shift in mental health delivery systems from a centralized to a decentralized community-based system requires quality service standards from both a professional and a service implementation viewpoint. The present paper sets forth the basic and preliminary structure for standards for crisis outreach services. Definitions are presented which…
Välimäki, Maritta; Yang, Min; Normand, Sharon-Lise; Lorig, Kate R; Anttila, Minna; Lantta, Tella; Pekurinen, Virve; Adams, Clive E
People admitted to psychiatric hospitals with a diagnosis of schizophrenia may display behavioural problems. These may require management approaches such as use of coercive practices, which impact the well-being of staff members, visiting families and friends, peers, as well as patients themselves. Studies have proposed that not only patients' conditions, but also treatment environment and ward culture may affect patients' behaviour. Seclusion and restraint could possibly be prevented with staff education about user-centred, more humane approaches. Staff education could also increase collaboration between patients, family members and staff, which may further positively affect treatment culture and lower the need for using coercive treatment methods. This is a single-blind, two-arm cluster randomised controlled trial involving 28 psychiatric hospital wards across Finland. Units will be randomised to receive either a staff educational programme delivered by the team of researchers, or standard care. The primary outcome is the incidence of use of patient seclusion rooms, assessed from the local/national health registers. Secondary outcomes include use of other coercive methods (limb restraint, forced injection, and physical restraint), service use, treatment satisfaction, general functioning among patients, and team climate and employee turn-over (nursing staff). The study, designed in close collaboration with staff members, patients and their relatives, will provide evidence for a co-operative and user-centred educational intervention aiming to decrease the prevalence of coercive methods and service use in the units, increase the functional status of patients and improve team climate in the units. We have identified no similar trials. ClinicalTrials.gov NCT02724748 . Registered on 25th of April 2016.
Dembo, Richard; Schmeidler, James; Wareham, Jennifer; Briones-Robinson, Rhissa; Winters, Ken C.; Ungaro, Rocio
The issue of delinquency among truant youths is insufficiently documented in the literature. There is a need to elucidate this issue, and assess the efficacy of interventions to reduce this problem behavior. The present National Institute on Drug Abuse (NIDA)-funded study addressed this gap by examining the impact of a Brief Intervention (BI),…
Waldemar, G; Waldorff, F B; Buss, D V
Background: There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline characteri......Background: There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline...
Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe
services to support relatives and to enable them to handle the situation. This study systematically reviewed the literature on the latest health service interventions targeting relatives of heart patients. METHODS: The literature about interventions targeting relatives of heart patients has been...
Anger management for people with mild to moderate learning disabilities: Study protocol for a multi-centre cluster randomized controlled trial of a manualized intervention delivered by day-service staff
Full Text Available Abstract Background Cognitive behaviour therapy (CBT is the treatment of choice for common mental health problems, but this approach has only recently been adapted for people with learning disabilities, and there is a limited evidence base for the use of CBT with this client group. Anger treatment is the one area where there exists a reasonable number of small controlled trials. This study will evaluate the effectiveness of a manualized 12-week CBT intervention for anger. The intervention will be delivered by staff working in the day services that the participants attend, following training to act as 'lay therapists' by a Clinical Psychologist, who will also provide supervision. Methods/Design This is a multi-centre cluster randomized controlled trial of a group intervention versus a 'support as usual' waiting-list control group, with randomization at the level of the group. Outcomes will be assessed at the end of the intervention and again 6-months later. After completion of the 6-month follow-up assessments, the intervention will also be delivered to the waiting-list groups. The study will include a range of anger/aggression and mental health measures, some of which will be completed by service users and also by their day service key-workers and by home carers. Qualitative data will be collected to assess the impact of the intervention on participants, lay therapists, and services, and the study will also include a service-utilization cost and consequences analysis. Discussion This will be the first trial to investigate formally how effectively staff working in services providing day activities for people with learning disabilities are able to use a therapy manual to deliver a CBT based anger management intervention, following brief training by a Clinical Psychologist. The demonstration that service staff can successfully deliver anger management to people with learning disabilities, by widening the pool of potential therapists, would have
such as diarrhoea with severe dehydration, meningitis, convulsions, acute asthma, and coma from various .... tea: at MINUTE mm. 0 use": mmmumu Aim! INEIVEIYIDN. Fzlgnne 2: ComPming tbe mean exeers time (minutes) between arrival and netnaltv being seen by the doetor before and enter intervention. each shift, the ...
Kalra, V S; Abel, P; Esmail, A
The National Health Service (NHS) is the largest employer in the U.K. but, despite decades of equal opportunities legislation, its senior management workforce does not reflect the diversity of either the wider NHS workforce or the U.K. population. The aim of the paper is to consider the range of management interventions available to organisations like the NHS to deliver change in the area of promotion of Black and minority ethnic staff. Intervention programmes in a range of public and private organisations are reviewed and the nature of barriers to promotion and the range of interventions to overcome these are explored. The paper uses the paradigm of institutional racism to examine the ways in which the NHS discriminates against certain sections of its workforce. The methods used include a literature review combined with key stakeholder interviews. A comparative dimension which involved a review of research on leadership initiatives in the U.S.A. was also undertaken. The literature review found that there were a range of initiatives which could be implemented by public organisations such as the NHS to increase the presence of Black and Minority Ethnic (BME) staff in senior management positions. Most of these interventions were largely focused on the individual. Much more progress on institutional or organisational change needed to be made before the NHS could be perceived as a model employer in this area. The literature review also indicated that there is little published research on such initiatives within other European Union countries. The paper is targeted at both policy makers and human resource officers responsible for equality and diversity issues within large organisations, who have a remit to improve the career pathways of staff. The analysis provided offers a set of critical tools and interventions that have not hitherto been well examined in the U.K. context.
Berryman, Mere; Woller, Paul
This paper examines Early Intervention (EI) service provision from within one Ministry of Education region in New Zealand. It does this in order to better understand what works well and what needs to change if children from Maori families, of Early Childhood age, are to be provided with the most effective EI services. By engaging with Maori…
A pragmatic randomised controlled trial of an implementation intervention to increase healthy eating and physical activity-promoting policies, and practices in centre-based childcare services: study protocol
Finch, Meghan; Yoong, Sze Lin; Thomson, Rebecca J; Seward, Kirsty; Cooney, Mairead; Jones, Jannah; Fielding, Alison; Wiggers, John; Gillham, Karen; Wolfenden, Luke
Background Promotion of healthy eating and physical activity in early childhood is recommended as a global chronic disease prevention strategy. Centre-based childcare services represent a promising setting to provide children with opportunities to improve healthy eating and physical activity. Evidence to inform implementation of childcare obesity prevention guidelines into routine practice in childcare, however, is lacking. This study aims to assess the effectiveness of an intervention, deliv...
Suominen, Svante; Pöyry-Lassila, Päivi
This paper presents first findings from a case study exploring the effectiveness of co-design interventions in the context of service co- development. The research approach was qualitative, comprising of three cases. Data was collected from follow-up interviews with organizations that have participated in researcher-led co-design interventions. As theoretical lens for analysing the case data we use theories of knowledge creation, service research, and process thinking, aiming to form a holist...
King, Gillian; Strachan, Deborah; Tucker, Michelle; Duwyn, Betty; Desserud, Sharon; Shillington, Monique
This article reviews the literature on the transdisciplinary approach to early intervention services and identifies the essential elements of this approach. A practice model describing the implementation of the approach is then presented, based on the experiences of staff members in a home visiting program for infants that has been in existence…
Jacobs, Elizabeth A; Sadowski, Laura S; Rathouz, Paul J
Many health care providers do not provide adequate language access services for their patients who are limited English-speaking because they view the costs of these services as prohibitive. However, little is known about the costs they might bear because of unaddressed language barriers or the costs of providing language access services. To investigate how language barriers and the provision of enhanced interpreter services impact the costs of a hospital stay. Prospective intervention study. Public hospital inpatient medicine service. Three hundred twenty-three adult inpatients: 124 Spanish-speakers whose physicians had access to the enhanced interpreter intervention, 99 Spanish-speakers whose physicians only had access to usual interpreter services, and 100 English-speakers matched to Spanish-speaking participants on age, gender, and admission firm. Patient satisfaction, hospital length of stay, number of inpatient consultations and radiology tests conducted in the hospital, adherence with follow-up appointments, use of emergency department (ED) services and hospitalizations in the 3 months after discharge, and the costs associated with provision of the intervention and any resulting change in health care utilization. The enhanced interpreter service intervention did not significantly impact any of the measured outcomes or their associated costs. The cost of the enhanced interpreter service was $234 per Spanish-speaking intervention patient and represented 1.5% of the average hospital cost. Having a Spanish-speaking attending physician significantly increased Spanish-speaking patient satisfaction with physician, overall hospital experience, and reduced ED visits, thereby reducing costs by $92 per Spanish-speaking patient over the study period. The enhanced interpreter service intervention did not significantly increase or decrease hospital costs. Physician-patient language concordance reduced return ED visit and costs. Health care providers need to examine all the
Banerjee Sushanta K
Full Text Available Abstract Background Unsafe abortion in India leads to significant morbidity and mortality. Abortion has been legal in India since 1971, and the availability of safe abortion services has increased. However, service availability has not led to a significant reduction in unsafe abortion. This study aimed to understand the gap between safe abortion availability and use of services in Bihar and Jharkhand, India by examining accessibility from the perspective of rural, Indian women. Methods Two-stage stratified random sampling was used to identify and enroll 1411 married women of reproductive age in four rural districts in Bihar and Jharkhand, India. Data were collected on women's socio-demographic characteristics; exposure to mass media and other information sources; and abortion-related knowledge, perceptions and practices. Multiple linear regression models were used to explore the association between knowledge and perceptions about abortion. Results Most women were poor, had never attended school, and had limited exposure to mass media. Instead, they relied on community health workers, family and friends for health information. Women who had knowledge about abortion, such as knowing an abortion method, were more likely to perceive that services are available (β = 0.079; p Conclusions Behavior change communication (BCC interventions, which address negative perceptions by improving community knowledge about abortion and support local availability of safe abortion services, are needed to increase enabling resources for women and improve potential access to services. Implementing BCC interventions is challenging in settings such as Bihar and Jharkhand where women may be difficult to reach directly, but interventions can target individuals in the community to transfer information to the women who need this information most. Interpersonal approaches that engage community leaders and influencers may also counteract negative social norms regarding
Aveling, Emma-Louise; Zegeye, Desalegn Tegabu; Silverman, Michael
Access to safe surgical care represents a critical gap in healthcare delivery and development in many low- and middle-income countries, including Ethiopia. Quality improvement (QI) initiatives at hospital level may contribute to closing this gap. Many such quality improvement initiatives are carried out through international health partnerships. Better understanding of how to optimise quality improvement in low-income settings is needed, including through partnership-based approaches. Drawing on a process evaluation of an intervention to improve surgical services in an Ethiopian hospital, this paper offers lessons to help meet this need. We conducted a qualitative process evaluation of a quality improvement project which aimed to improve access to surgical services in an Ethiopian referral hospital through better management. Data was collected longitudinally and included: 66 in-depth interviews with surgical staff and project team members; observation (135 h) in the surgery department and of project meetings; project-related documentation. Thematic analysis, guided by theoretical constructs, focused on identifying obstacles to implementation. The project largely failed to achieve its goals. Key barriers related to project design, partnership working and the implementation context, and included: confusion over project objectives and project and partner roles and responsibilities; logistical challenges concerning overseas visits; difficulties in communication; gaps between the time and authority team members had and that needed to implement and engage other staff; limited strategies for addressing adaptive-as opposed to technical-challenges; effects of hierarchy and resource scarcity on QI efforts. While many of the obstacles identified are common to diverse settings, our findings highlight ways in which some features of low-income country contexts amplify these common challenges. We identify lessons for optimising the design and planning of quality improvement
Stewart, Clarence, M., Jr.
This article deals with a service-learning program focused on human sexuality and HIV/AIDS prevention and intervention at the Howard University Department of Health, Human Performance and Leisure Studies. Topics discussed include how this program was created, an overview of peer education, HIV/AIDS peer education training, and services provided to…
Tsetis, Dimitrios, E-mail: email@example.com [University of Crete, Interventional Radiology Unit, Department of Radiology, University Hospital Heraklion, Faculty of Medicine (Greece); Uberoi, Raman, E-mail: firstname.lastname@example.org [John Radcliff Hospital, Radiology Department (United Kingdom); Fanelli, Fabrizio, E-mail: email@example.com [Sapienza – University of Rome, Interventional Radiology Unit, Department of Radiological Sciences (Italy); Roberston, Iain, E-mail: firstname.lastname@example.org [Gartnavel General Hospital, Interventional Radiology Unit (United Kingdom); Krokidis, Miltiadis, E-mail: email@example.com [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology (United Kingdom); Delden, Otto van, E-mail: firstname.lastname@example.org [Academic Medical Center, Department of Radiology (Netherlands); Radeleff, Boris, E-mail: email@example.com [University Hospital of Heidelberg, Department for Diagnostic and Interventional Radiology (Germany); Müller-Hülsbeck, Stefan, E-mail: firstname.lastname@example.org [Ev.-Luth. Diakonissenanstalt zu Flensburg – Zentrum für Gesundheit und Diakonie, Diagnostische u. Interventionelle Radiologie/Neuroradiologie (Germany); Szerbo-Trojanowska, Malgorzata, E-mail: email@example.com [Medical University of Lublin, Interventional Radiology (Poland); Lee, Michael, E-mail: firstname.lastname@example.org [Beaumont Hospital, Department of Radiology (Ireland); Morgan, Robert, E-mail: email@example.com [St George’s Hospital, Department of Radiology (United Kingdom); Brountzos, Elias, E-mail: firstname.lastname@example.org [National and Kapodistrian University of Athens (Greece); Belli, Anna Maria, E-mail: Anna.email@example.com [St George’s Hospital, Department of Radiology (United Kingdom)
Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.
Hülsheger, Ute R; Lang, Jonas W B; Schewe, Anna F; Zijlstra, Fred R H
We investigated the relationship between deep acting, automatic regulation and customer tips with 2 different study designs. The first study was a daily diary study using a sample of Dutch waiters and taxi-drivers and assessed the link of employees' daily self-reported levels of deep acting and automatic regulation with the amount of tips provided by customers (N = 166 measurement occasions nested in 34 persons). Whereas deep acting refers to deliberate attempts to modify felt emotions and involves conscious effort, automatic regulation refers to automated emotion regulatory processes that result in the natural experience of desired emotions and do not involve deliberate control and effort. Multilevel analyses revealed that both types of emotion regulation were positively associated with customer tips. The second study was an experimental field study using a sample of German hairdressers (N = 41). Emotion regulation in terms of both deep acting and automatic regulation was manipulated using a brief self-training intervention and daily instructions to use cognitive change and attentional deployment. Results revealed that participants in the intervention group received significantly more tips than participants in the control group. PsycINFO Database Record (c) 2015 APA, all rights reserved.
McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk
Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (peducation. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.
Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.
Zitelli, Lori; Palmer, Catherine V
Although older adults are likely to experience some degree of hearing loss that if untreated will interfere with treatment for other disorders and result in less-than-optimal health care outcomes, health care providers do not have a reliable and cost-effective way to identify these individuals when admitted to a hospital for inpatient care. This article addresses the impact of untreated hearing loss on health care in a hospital setting and shares how the implementation of interventional audiology in an outpatient clinic has impacted the inpatient audiology services provided at a large tertiary care hospital. A discussion of how these services can be further expanded is provided.
Adamson, S. [Dowell, Las Morochas (Venezuela); Cupello, F.; Hicks, J.; Keenleyside, M. [Sedco Forex, Las Morochas (Venezuela); Formas, D.; Gabillard, C. [Sedco Forex, Montrouge (France); Gamarra, F.; Sanchez, A. [Lagoven SA, Tia Juana (Venezuela)
The industry has entered a new area in offshore support operations. Today, novel concepts and designs offer an expanded range of capabilities from a single vessel rather than the multiple boats and barges that have been used in the past. This continuing evolution in marine services is rapidly transforming well workover and intervention activities, and solving logistics and performance problems that have challenged oil and gas operators for decades. 13 figs., 5 refs.
A pragmatic randomised controlled trial of an implementation intervention to increase healthy eating and physical activity-promoting policies, and practices in centre-based childcare services: study protocol.
Finch, Meghan; Yoong, Sze Lin; Thomson, Rebecca J; Seward, Kirsty; Cooney, Mairead; Jones, Jannah; Fielding, Alison; Wiggers, John; Gillham, Karen; Wolfenden, Luke
Promotion of healthy eating and physical activity in early childhood is recommended as a global chronic disease prevention strategy. Centre-based childcare services represent a promising setting to provide children with opportunities to improve healthy eating and physical activity. Evidence to inform implementation of childcare obesity prevention guidelines into routine practice in childcare, however, is lacking. This study aims to assess the effectiveness of an intervention, delivered to childcare staff, aiming to increasing service implementation of healthy eating and physical activity-promoting policies and practices. A pragmatic parallel group randomised controlled trial will be undertaken with 165 childcare services in the Hunter New England region of New South Wales, Australia. Services will be randomised to receive either a 10-month evidence-based performance review intervention with other resources to support practice change, or to a waitlist control group. The primary trial outcome is the proportion of services implementing all of the following recommended healthy eating and physical activity promoting practices: written nutrition, physical activity and small screen recreation policies; providing information to families regarding healthy eating (including breastfeeding), physical activity and small screen time; providing twice weekly healthy eating learning experiences to children; providing water and only plain milk to children; providing fundamental movement skills activities for children every day; and limiting and using electronic screen time more for educational purposes and learning experiences. Effectiveness will be assessed using a telephone interview of practice implementation with childcare staff at baseline and 12 months following baseline. The study was approved by the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee. Study findings will be disseminated widely through peer
Strömbäck, Maria; Malmgren-Olsson, Eva-Britt; Wiklund, Maria
Mental health problems among young people, and girls and young women in particular, are a well-known health problem. Such gendered mental health patterns are also seen in conjunction with stress-related problems, such as anxiety and depression and psychosomatic complaints. Thus, intervention models tailored to the health care situation experienced by young women within a gendered and sociocultural context are needed. This qualitative study aims to illuminate young women's experiences of participating in a body-based, gender-sensitive stress management group intervention by youth-friendly health services in northern Sweden. A physiotherapeutic body-based, health-promoting, gender-sensitive stress management intervention was created by youth-friendly Swedish health services. The stress management courses (n = 7) consisted of eight sessions, each lasting about two hours, and were led by the physiotherapist at the youth centre. The content in the intervention had a gender-sensitive approach, combining reflective discussions; short general lectures on, for example, stress and pressures related to body ideals; and physiotherapeutic methods, including body awareness and relaxation. Follow-up interviews were carried out with 32 young women (17-25 years of age) after they had completed the intervention. The data were analysed with qualitative content analysis. The overall results of our interview analysis suggest that the stress management course we evaluated facilitated 'a space for gendered and embodied empowerment in a hectic life', implying that it both contributed to a sense of individual growth and allowed participants to unburden themselves of stress problems within a trustful and supportive context. Participants' narrated experiences of 'finding a social oasis to challenge gendered expectations', 'being bodily empowered', and 'altering gendered positions and stance to life' point to empowering processes of change that allowed them to cope with distress, despite
Background Mental health problems among young people, and girls and young women in particular, are a well-known health problem. Such gendered mental health patterns are also seen in conjunction with stress-related problems, such as anxiety and depression and psychosomatic complaints. Thus, intervention models tailored to the health care situation experienced by young women within a gendered and sociocultural context are needed. This qualitative study aims to illuminate young women’s experiences of participating in a body-based, gender-sensitive stress management group intervention by youth-friendly health services in northern Sweden. Methods A physiotherapeutic body-based, health-promoting, gender-sensitive stress management intervention was created by youth-friendly Swedish health services. The stress management courses (n = 7) consisted of eight sessions, each lasting about two hours, and were led by the physiotherapist at the youth centre. The content in the intervention had a gender-sensitive approach, combining reflective discussions; short general lectures on, for example, stress and pressures related to body ideals; and physiotherapeutic methods, including body awareness and relaxation. Follow-up interviews were carried out with 32 young women (17–25 years of age) after they had completed the intervention. The data were analysed with qualitative content analysis. Results The overall results of our interview analysis suggest that the stress management course we evaluated facilitated ‘a space for gendered and embodied empowerment in a hectic life’, implying that it both contributed to a sense of individual growth and allowed participants to unburden themselves of stress problems within a trustful and supportive context. Participants’ narrated experiences of ‘finding a social oasis to challenge gendered expectations’, ‘being bodily empowered’, and ‘altering gendered positions and stance to life’ point to empowering processes of change that
Ziviani, Jenny; Darlington, Yvonne; Feeney, Rachel; Rodger, Sylvia; Watter, Pauline
To gain insight into the special issues confronting parents when accessing early intervention for children with physical disabilities where child and/or family characteristics indicate complex needs within the unique Australian context. Qualitative interviews with families receiving early intervention for their children with physical disabilities (N=10). Families with complex circumstances such as having children with high support needs, those from culturally and linguistically diverse backgrounds, and single-parent families were recruited to the study. Families where parents had mental or health issues, parents/other family members had an identified disability, and/or where families lived in regional or rural locations were also purposively sampled. Participants highlighted issues around (i) the nature of early intervention services provided; (ii) the ways in which services were structured; and (ii) managing their child's needs/planning into the future. Parents stressed the importance of having access to a variety of early intervention services aside from therapy. They also emphasised the need for greater clarity about what to expect from services, the intensity of therapy, other services they could access and how long they would be able to receive these. Despite their complex circumstances and needs, participants' experiences of accessing early intervention services were largely consistent with the broader research literature. Of the parents interviewed, those with health problems and single mothers expressed most apprehension about managing their child's needs and planning for the future. © 2013 Occupational Therapy Australia.
Coast, Ernestina; Jones, Eleri; Portela, Anayda; Lattof, Samantha R.
Background A vast body of global research shows that cultural factors affect the use of skilled maternity care services in diverse contexts. While interventions have sought to address this issue, the literature on these efforts has not been synthesised. This paper presents a systematic mapping of interventions that have been implemented to address cultural factors that affect women's use of skilled maternity care. It identifies and develops a map of the literature; describes the range of interventions, types of literature and study designs; and identifies knowledge gaps. Methods and Findings Searches conducted systematically in ten electronic databases and two websites for literature published between 01/01/1990 and 28/02/2013 were combined with expert-recommended references. Potentially eligible literature included journal articles and grey literature published in English, French or Spanish. Items were screened against inclusion and exclusion criteria, yielding 96 items in the final map. Data extracted from the full text documents are presented in tables and a narrative synthesis. The results show that a diverse range of interventions has been implemented in 35 countries to address cultural factors that affect the use of skilled maternity care. Items are classified as follows: (1) service delivery models; (2) service provider interventions; (3) health education interventions; (4) participatory approaches; and (5) mental health interventions. Conclusions The map provides a rich source of information on interventions attempted in diverse settings that might have relevance elsewhere. A range of literature was identified, from narrative descriptions of interventions to studies using randomised controlled trials to evaluate impact. Only 23 items describe studies that aim to measure intervention impact through the use of experimental or observational-analytic designs. Based on the findings, we identify avenues for further research in order to better document and measure
Full Text Available A vast body of global research shows that cultural factors affect the use of skilled maternity care services in diverse contexts. While interventions have sought to address this issue, the literature on these efforts has not been synthesised. This paper presents a systematic mapping of interventions that have been implemented to address cultural factors that affect women's use of skilled maternity care. It identifies and develops a map of the literature; describes the range of interventions, types of literature and study designs; and identifies knowledge gaps.Searches conducted systematically in ten electronic databases and two websites for literature published between 01/01/1990 and 28/02/2013 were combined with expert-recommended references. Potentially eligible literature included journal articles and grey literature published in English, French or Spanish. Items were screened against inclusion and exclusion criteria, yielding 96 items in the final map. Data extracted from the full text documents are presented in tables and a narrative synthesis. The results show that a diverse range of interventions has been implemented in 35 countries to address cultural factors that affect the use of skilled maternity care. Items are classified as follows: (1 service delivery models; (2 service provider interventions; (3 health education interventions; (4 participatory approaches; and (5 mental health interventions.The map provides a rich source of information on interventions attempted in diverse settings that might have relevance elsewhere. A range of literature was identified, from narrative descriptions of interventions to studies using randomised controlled trials to evaluate impact. Only 23 items describe studies that aim to measure intervention impact through the use of experimental or observational-analytic designs. Based on the findings, we identify avenues for further research in order to better document and measure the impact of interventions to
Coast, Ernestina; Jones, Eleri; Portela, Anayda; Lattof, Samantha R
A vast body of global research shows that cultural factors affect the use of skilled maternity care services in diverse contexts. While interventions have sought to address this issue, the literature on these efforts has not been synthesised. This paper presents a systematic mapping of interventions that have been implemented to address cultural factors that affect women's use of skilled maternity care. It identifies and develops a map of the literature; describes the range of interventions, types of literature and study designs; and identifies knowledge gaps. Searches conducted systematically in ten electronic databases and two websites for literature published between 01/01/1990 and 28/02/2013 were combined with expert-recommended references. Potentially eligible literature included journal articles and grey literature published in English, French or Spanish. Items were screened against inclusion and exclusion criteria, yielding 96 items in the final map. Data extracted from the full text documents are presented in tables and a narrative synthesis. The results show that a diverse range of interventions has been implemented in 35 countries to address cultural factors that affect the use of skilled maternity care. Items are classified as follows: (1) service delivery models; (2) service provider interventions; (3) health education interventions; (4) participatory approaches; and (5) mental health interventions. The map provides a rich source of information on interventions attempted in diverse settings that might have relevance elsewhere. A range of literature was identified, from narrative descriptions of interventions to studies using randomised controlled trials to evaluate impact. Only 23 items describe studies that aim to measure intervention impact through the use of experimental or observational-analytic designs. Based on the findings, we identify avenues for further research in order to better document and measure the impact of interventions to address
IMPlementation of A Relatives' Toolkit (IMPART study): an iterative case study to identify key factors impacting on the implementation of a web-based supported self-management intervention for relatives of people with psychosis or bipolar experiences in a National Health Service: a study protocol.
Lobban, Fiona; Appleton, Victoria; Appelbe, Duncan; Barraclough, Johanna; Bowland, Julie; Fisher, Naomi R; Foster, Sheena; Johnson, Sonia; Lewis, Elizabeth; Mateus, Céu; Mezes, Barbara; Murray, Elizabeth; O'Hanlon, Puffin; Pinfold, Vanessa; Rycroft-Malone, Jo; Siddle, Ron; Smith, Jo; Sutton, Chris J; Walker, Andrew; Jones, Steven H
Web-based interventions to support people to manage long-term health conditions are available and effective but rarely used in clinical services. The aim of this study is to identify critical factors impacting on the implementation of an online supported self-management intervention for relatives of people with recent onset psychosis or bipolar disorder into routine clinical care and to use this information to inform an implementation plan to facilitate widespread use and inform wider implementation of digital health interventions. A multiple case study design within six early intervention in psychosis (EIP) services in England, will be used to test and refine theory-driven hypotheses about factors impacting on implementation of the Relatives' Education And Coping Toolkit (REACT). Qualitative data including behavioural observation, document analysis, and in-depth interviews collected in the first two EIP services (wave 1) and analysed using framework analysis, combined with quantitative data describing levels of use by staff and relatives and impact on relatives' distress and wellbeing, will be used to identify factors impacting on implementation. Consultation via stakeholder workshops with staff and relatives and co-facilitated by relatives in the research team will inform development of an implementation plan to address these factors, which will be evaluated and refined in the four subsequent EIP services in waves 2 and 3. Transferability of the implementation plan to non-participating services will be explored. Observation of implementation in a real world clinical setting, across carefully sampled services, in real time provides a unique opportunity to understand factors impacting on implementation likely to be generalizable to other web-based interventions, as well as informing further development of implementation theories. However, there are inherent challenges in investigating implementation without influencing the process under observation. We outline our
Becker, Mackenzie; Cunningham, Charles E; Christensen, Bruce K; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Madsen, Victoria; Bieling, Peter; Chen, Yvonne; Mielko, Stephanie; Zipursky, Robert B
To understand what service features would sustain patient engagement in early intervention mental health treatment. Mental health patients, family members of individuals with mental illness and mental health professionals completed a survey consisting of 18 choice tasks that involved 14 different service attributes. Preferences were ascertained using importance and utility scores. Latent class analysis revealed segments characterized by distinct preferences. Simulations were carried out to estimate utilization of hypothetical clinical services. Overall, 333 patients and family members and 183 professionals (N = 516) participated. Respondents were distributed between a Professional segment (53%) and a Patient segment (47%) that differed in a number of their preferences including for appointment times, individual vs group sessions and mode of after-hours support. Members of both segments shared preferences for many of the service attributes including having crisis support available 24 h per day, having a choice of different treatment modalities, being offered help for substance use problems and having a focus on improving symptoms rather than functioning. Simulations predicted that 60% of the Patient segment thought patients would remain engaged with a Hospital service, while 69% of the Professional segment thought patients would be most likely to remain engaged with an E-Health service. Patients, family members and professionals shared a number of preferences about what service characteristics will optimize patient engagement in early intervention services but diverged on others. Providing effective crisis support as well as a range of treatment options should be prioritized in the future design of early intervention services. © 2017 John Wiley & Sons Australia, Ltd.
Nadon, N L; Strong, R; Miller, R A; Nelson, J; Javors, M; Sharp, Z D; Peralba, J M; Harrison, D E
The field of biogerontology has made great strides towards understanding the biological processes underlying aging, and the time is ripe to look towards applying this knowledge to the pursuit of aging interventions. Identification of safe, inexpensive, and non-invasive interventions that slow the aging process and promote healthy aging could have a significant impact on quality of life and health care expenditures for the aged. While there is a plethora of supplements and interventions on the market that purport to slow aging, the evidence to validate such claims is generally lacking. Here we describe the development of an aging interventions testing program funded by the National Institute on Aging (NIA) to test candidate interventions in a model system. The development of this program highlights the challenges of long-term intervention studies and provides approaches to cope with the stringent requirements of a multi-site testing program.
Nguyen, Cathina T.; Krakowiak, Paula; Hansen, Robin; Hertz-Picciotto, Irva; Angkustsiri, Kathleen
This study investigates whether sociodemographic factors are associated with utilization of intervention services for children with autism spectrum disorder (ASD) enrolled in the Childhood Autism Risks from Genetics and the Environment Study. Maternal ethnicity, insurance status, and education for 696 families of children with ASD were available.…
Francisković, Tanja; Tovilović, Zdravko; Suković, Zoran; Stevanović, Aleksandra; Ajduković, Dean; Kraljević, Radojka; Bogić, Marija; Priebe, Stefan
To explore the use of health care and community-based services in war-affected regions of Croatia and its relation to mental health. A sample of 719 adults exposed to at least one war-related traumatic event were selected by random-walk technique from three Croatian counties and interviewed for socio-demographic data, mental health status (Mini International Neuropsychiatric Interview), and service use (Matrix for the Assessment of Community and Healthcare Services) in the period from 1991 to 2006. Descriptive analysis of service use was performed. Relations between service use, current mental health, and recovery from posttraumatic stress disorder (PTSD) were analyzed using logistic regression models. The traumatized population used a wide range of health care and community-based services. Health care was the most frequently used service category, especially primary health care (92.5%), followed by accommodation support (57.9%), financial support (57.7%), and employment support (32.5%). Compared with participants without mental disorders, participants with current PTSD were more likely to use only legal support (odds ratio [OR], 2.15; 95% confidence interval [CI], 1.15-3.99), while participants with other mental disorders were more likely to use social support and contacts (OR, 1.72; 95% CI, 1.08-2.75). Receiving accommodation support (OR, 2.05; 95% CI, 1.03-4.06) was the only significant predictor of recovery from PTSD, while seeking legal support (OR, 0.28; 95% CI, 0.08-0.92) was related to slower recovery. Although a wide range of services were organized to help the traumatized population in Croatia, only the solution of housing issue significantly predicted recovery. The organization of help services should take into consideration the existing infrastructure and local specificities, and respect the needs of people in war-affected areas.
Bryant, Jamie; Bonevski, Billie; Paul, Christine; O'Brien, Jon; Oakes, Wendy
.... Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting...
Cong Van Tran; Bahr Weiss; Toan Nang Khuc; Thu Thi Le Tran; Trang Thi Nha Nguyen; Hoa Thi Kim Nguyen; Thuy Thi Thu Dao
Background In high income countries in Europe and North America, early identification and intervention for autism spectrum disorders (ASD) have been linked to improved long-term outcomes. However, in most low and middle income countries (LMIC) little is known about the use or availability of such services, which limits the ability of policy and development planning. The purpose of the present study was to assess the use of ASD services in a number of cities in Vietnam, an Asian LMIC, in ...
Newby, Katie V; Brown, Katherine E; Bayley, Julie; Kehal, Isher; Caley, Mike; Danahay, Amy; Hunt, Jonny; Critchley, George
This study aimed to develop and implement an intervention, delivered via a website and Web app, to increase the uptake of sexual health services by young people. The intervention was co-designed with a group of 10 young people. Intervention mapping was used to guide development. To identify barriers and facilitators of access to sexual health services, three focus groups with 24 young people aged 13 to 19 years, and interviews with 12 professionals recruited from across a range of health and social services, were conducted. Data were analyzed using content analysis. Evidence was supplemented through a literature review. Barriers and facilitators were categorized as theoretical determinants and then suitable behavior change techniques (BCTs) for targeting them were selected. Targeted determinants were attitude, subjective norm, perceived behavioral control, and knowledge. Selected BCTs included "information about others' approval," "framing/reframing," and "credible source." The website/app enable users to search for services, access key information about them, watch videos about what to expect, and have key concerns removed/addressed. This is the first known digital evidence-based intervention to target this behavior described in the literature. A clear and full description of intervention development and content, including of theorized causal pathways, is provided to aid interpretation of future outcome evaluations.
Krauss, Inga; Mueller, Gerhard; Haupt, Georg; Steinhilber, Benjamin; Janssen, Pia; Jentner, Nicola; Martus, Peter
Osteoarthritis is the most common reason for pain in older adults, and the individual and economic burden of this disease is immense. The chronic character of osteoarthritis requires a long-term therapeutic treatment. In this regard life-style interventions such as physical exercises that can be carried out by the patient himself are recommended as first line treatment. There is evidence for the short-term benefit of exercise therapy in terms of pain reduction and physical functioning. Nonetheless research agendas highlight the need for multifaceted interventions that incorporate exercise strategies into patient care. Studies should be conducted with appropriate sample sizes and should allow statements on long-term effects as well as cost-utility and safety. These open questions are under the scope of this study. This is a controlled study in the context of health services research. The study population consists of n = 1400 subjects with hip or knee osteoarthritis. The intervention group will be recruited from participants of a country-wide health insurance offer for people with hip or knee osteoarthritis. Potential participants for the control group (ratio 10:1 (control vs. intervention) will be filtered out from the insurance data base according to pre-defined matching criteria and asked by letter for their participation. The final statistical twins from the responders (1:1) will be determined via propensity score matching. The progressive training intervention comprises 8 supervised group sessions, supplemented by home exercises (2/week over 11 weeks). Exercises include mobilization, strengthening and training of postural control. Primary outcomes are pain and function measured with the WOMAC Index immediately after the intervention period. Among other things, health related quality of life, self-efficacy, cost utility and safety will be evaluated as secondary outcomes. Participants will be followed up 6, 12 and 24 month after baseline. Results of this
Full Text Available Abstract Background Osteoarthritis is the most common reason for pain in older adults, and the individual and economic burden of this disease is immense. The chronic character of osteoarthritis requires a long-term therapeutic treatment. In this regard life-style interventions such as physical exercises that can be carried out by the patient himself are recommended as first line treatment. There is evidence for the short-term benefit of exercise therapy in terms of pain reduction and physical functioning. Nonetheless research agendas highlight the need for multifaceted interventions that incorporate exercise strategies into patient care. Studies should be conducted with appropriate sample sizes and should allow statements on long-term effects as well as cost-utility and safety. These open questions are under the scope of this study. Methods/design This is a controlled study in the context of health services research. The study population consists of n = 1400 subjects with hip or knee osteoarthritis. The intervention group will be recruited from participants of a country-wide health insurance offer for people with hip or knee osteoarthritis. Potential participants for the control group (ratio 10:1 (control vs. intervention will be filtered out from the insurance data base according to pre-defined matching criteria and asked by letter for their participation. The final statistical twins from the responders (1:1 will be determined via propensity score matching. The progressive training intervention comprises 8 supervised group sessions, supplemented by home exercises (2/week over 11 weeks. Exercises include mobilization, strengthening and training of postural control. Primary outcomes are pain and function measured with the WOMAC Index immediately after the intervention period. Among other things, health related quality of life, self-efficacy, cost utility and safety will be evaluated as secondary outcomes. Participants will be followed up 6
Bhopti, Anoo; Brown, Ted; Lentin, Primrose
A scoping review was conducted to identify factors influencing the quality of life of families of children with disability. The review also explored the scales used to measure family quality of life (FQOL) as an outcome in early childhood intervention services (ECIS). Multiple databases were searched from 2000 to 2013 to include studies pertinent…
Pei, Jacqueline; Baugh, Lauren; Andrew, Gail; Rasmussen, Carmen
Children with fetal alcohol spectrum disorders (FASD) and prenatal alcohol exposure (PAE) experience multiple difficulties requiring various interventions. Researchers have called for investigation into service use with respect to clinically recommended interventions. To examine intervention recommendations for children with FASD/PAE and subsequent access to these recommended interventions. Intervention recommendations following FASD assessment were examined for children (1-17 years). Recommendations were compared according to diagnostic status and demographic and environmental variables. Subsequent access to several interventions was examined for 45 participants. A variety of recommendations were given. Children with FASD received more recommendations overall and received more education, anticipatory guidance, family support, and safety recommendations than undiagnosed children with PAE. Undiagnosed children received more mental health and reassessment recommendations. Older children received fewer family support and developmental therapy recommendations but more mental health recommendations than younger age groups. Many families accessed modified school programming, developmental therapy, psychiatry, child counseling, and parent support as recommended. Children with FASD and PAE have extensive needs and should receive individualized recommendations. An assessment is valuable even without an FASD diagnosis. Areas of high/low service access may provide insight into accessibility and perceived importance of interventions. This study responds to important research questions regarding the intervention needs of individuals with FASD. It is novel in its exploration of intervention recommendations given to children prenatally exposed to alcohol without an FASD diagnosis (rather than only children with FASD) and in its examination of post-assessment service use patterns specifically in relation to clinical recommendations. Crown Copyright © 2016. Published by Elsevier
Melville, C. A.; Cooper, S.-A.; Morrison, J.; Finlayson, J.; Allan, L.; Robinson, N.; Burns, E.; Martin, G.
Background: People with intellectual disabilities (IDs) experience significant health inequalities compared with the general population. The barriers people with IDs experience in accessing services contribute to these health inequalities. Professionals' significant unmet training needs are an important barrier to people with IDs accessing…
Cong Van Tran
Full Text Available Background In high income countries in Europe and North America, early identification and intervention for autism spectrum disorders (ASD have been linked to improved long-term outcomes. However, in most low and middle income countries (LMIC little is known about the use or availability of such services, which limits the ability of policy and development planning. The purpose of the present study was to assess the use of ASD services in a number of cities in Vietnam, an Asian LMIC, in order to identify areas within the field that should be specifically targeted to improve ASD services in Vietnam. Participants and procedure Surveys were conducted in six different cities across Vietnam with 90 parents/caregivers of children with ASD, 115 professionals working with children with ASD, and 10 directors of agencies providing ASD services. The parents/caregivers’ survey assessed demographics and information regarding their child’s symptoms and services the child received. The professionals’ survey assessed their demographic and professional background, the ASD services they provide, and their perspective on the quality of ASD services at their agency. The directors’ survey included these same questions as well as additional questions regarding the operation of the agency. Results Early identification and intervention ASD services are available in Vietnam, at least in major cities. However, there is a lack of well-trained professionals, the tools used for evaluation and diagnosis are limited, outdated and unstandardized, and the quality of services is questionable. Most importantly, a scientific evidence base for services is absent, and the country lacks an official governmental policy for supporting children with ASD. Conclusions Research directly assessing the quality of ASD services in Vietnam is needed. Most importantly, efforts at facilitating governmental policy and support advocacy are needed to increase the likelihood that families and
Full Text Available All blood bank services, especially those of developing countries, face a major shortfall of blood donations due to lack of voluntary blood donors. Our study aims to evaluate the acceptability of Short Message Service based interventions towards becoming voluntary blood donors among medical university students of Karachi, Pakistan. Methods. A total of 350 medical students were approached in medical universities of Karachi, Pakistan, using a nonprobability convenient sampling technique. Data collectors administered a self-made questionnaire to each participant using an interview based format. All data was recorded and analyzed on SPSS 16. Results. 350 participants, having a mean age of 21.47 ± 1.36, were included in our study with 30.6% (107/350 being males and 69.4% (243/350 being females. 93.4% (327/350 of participants agreed that donating blood was healthy, but only 26% had donated blood in the past with 79.1% donating voluntarily. 65.7% (230/350 of the participants agreed to take part in Short Message Service based behavioral interventions to become voluntary blood donors with 69.7% (244/350 also agreeing that Short Message Service reminders will promote them to donate blood more often. Conclusion. With university students willing to become voluntary blood donors, Pakistani blood banks can carry out Short Message Service based interventions to encourage them to donate blood.
Araujo, Miguel; Moraga, Cecilia; Chapman, Evelina; Barreto, Jorge; Illanes, Eduardo
Synthesize evidence on effectiveness of interventions designed to improve access to health services by indigenous populations. Review of systematic reviews published as of July 2015, selecting and analyzing only studies in the Region of the Americas. The bibliographic search encompassed MEDLINE, Lilacs, SciELO, EMBASE, DARE, HTA, The Cochrane Library, and organization websites. Two independent reviewers selected studies and analyzed their methodological quality. A narrative summary of the results was produced. Twenty-two reviews met the inclusion criteria. All selected studies were conducted in Canada and the United States of America. The majority of the interventions were preventive, to surmount geographical barriers, increase use of effective measures, develop human resources, and improve people's skills or willingness to seek care. Topics included pregnancy, cardiovascular risk factors, diabetes, substance abuse, child development, cancer, mental health, oral health, and injuries. Some interventions showed effectiveness with moderate or high quality studies: educational strategies to prevent depression, interventions to prevent childhood caries, and multicomponent programs to promote use of child safety seats. In general, results for chronic non-communicable diseases were negative or inconsistent. Interventions do exist that have potential for producing positive effects on access to health services by indigenous populations in the Americas, but available studies are limited to Canada and the U.S. There is a significant research gap on the topic in Latin America and the Caribbean.
Mosack, Katie E; Wendorf, Angela R; Brouwer, Amanda M; Patterson, Leslie; Ertl, Kristyn; Whittle, Jeff; Morzinski, Jeff; Fletcher, Kathlyn
The purpose of this study was to determine the influence of program factors on participant engagement in POWER, a peer-led intervention designed to reduce hypertension, increase hypertension knowledge, and improve other relevant health behaviors, such as diet and exercise, among US veterans involved in veterans service organizations throughout Southeastern Wisconsin. Two hundred and nineteen hypertensive members from 58 VSOs participated in a year-long peer-led intervention designed to improve hypertension knowledge, disease self-management behaviors, and health outcomes. This study represents a qualitative evaluation of post and participant engagement in this intervention. We triangulated data collected via three qualitative approaches (observations, focus groups, and in-depth interviews) from intervention posts to derive a model of engagement. Our findings indicate that discrete characteristics of the peer leaders, post members, posts, and the intervention itself contributed to intervention engagement. We make suggestions for future research studies, particularly as related to understanding how peer leader identities and cultural norms within VSOs might contribute to peer-led health intervention success.
MacPherson, Peter; Munthali, Chigomezgo; Ferguson, Jane; Armstrong, Alice; Kranzer, Katharina; Ferrand, Rashida A; Ross, David A
Adolescents living with HIV face substantial difficulties in accessing HIV care services and have worse treatment outcomes than other age groups. The objective of this review was to evaluate the effectiveness of service delivery interventions to improve adolescents' linkage from HIV diagnosis to antiretroviral therapy (ART) initiation, retention in HIV care and adherence to ART. We systematically searched the Medline, SCOPUS and Web of Sciences databases and conference abstracts from the International AIDS Conference and International Conference on AIDS and STIs in Africa (ICASA). Studies published in English between 1st January 2001 and 9th June 2014 were included. Two authors independently evaluated reports for eligibility, extracted data and assessed methodological quality using the Cochrane risk of bias tool and Newcastle-Ottawa Scale. Eleven studies from nine countries were eligible for review. Three studies were randomised controlled trials. Interventions assessed included individual and group counselling and education; peer support; directly observed therapy; financial incentives; and interventions to improve the adolescent-friendliness of clinics. Most studies were of low to moderate methodological quality. This review identified limited evidence on the effectiveness of service delivery interventions to support adolescents' linkage from HIV diagnosis to ART initiation, retention on ART and adherence to ART. Although recommendations are qualified because of the small numbers of studies and limited methodological quality, offering individual and group education and counselling, financial incentives, increasing clinic accessibility and provision of specific adolescent-tailored services appear promising interventions and warrant further investigation. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Ireland, Anthony W
The burden of healthcare costs for persons approaching death is of increasing concern. This study examines cost savings associated with access to palliative care (PC) during a hospital episode ending in death for a large sample of elderly patients. A retrospective cohort study of administrative data for the Department of Veterans' Affairs clients identified patient demographics, hospital characteristics, utilisation data and component costs for the hospital terminal episode for patients aged ≥ 70 years who died in hospital between July 2011 and June 2015. Differences between patients with and without access to PC were analysed with descriptive statistics and negative binomial regression models. Access to PC service was reported for 33.2% of patients, 59.5% for those with a cancer diagnosis and 24.3% for other patients. Rates were significantly lower in private hospitals for all patient groups. For the complete sample, PC access was associated with significantly lower rates of admission into the intensive care unit (1.9% vs 10.6%, P terminal episodes was $10 801 for PC patients and $16 165 for those with no recorded PC access (P < 0.001). All differences remained significant after adjustment for patient age, comorbidity and hospital type. In a hospital episode ending in death, access to PC services was associated with significantly lower rates of medical interventions and total hospital costs. © 2017 Commonwealth of Australia Internal Medicine Journal © 2017 Royal Australasian College of Physicians.
A pre- and post-intevention randomized cross-sectional study was carried out from January to February and April to May 2001, respectively, to audit and intervene in the timeliness of health services delivery in an Emergency Paediatric Unit (EPU) of Jos University Teaching Hospital. A structured questionnaire was used to ...
Full Text Available Nowadays, drug research and surveillance after authorisation becomes more and more important for several reasons. Non-interventional studies (NIS investigate various aspects of drug use including efficacy and safety under real life conditions. Such kind of health services research should be on a high scientific, methodological and organisational level. Therefore accompanying measures to improve or to keep the quality are highly recommended. The aim of quality management is: first to avoid bias of results by using an appropriate study design and an adequate data analysis, second to assure authenticity, completeness and validity of the data and third to identify and resolve deficiencies at an early stage. Basic principles are laid down in corresponding guidelines and recommendations of authorities, institutes and societies. Various guidelines for good epidemiological practice (GEP were published by the U.S. Food and Drug Administration (FDA and international and regional societies for epidemiology. In addition in Germany the Federal Institute for Drugs and Medical Devices (BfArM together with the Paul Ehrlich Institute (PEI and the German Association of Research-Based Pharmaceutical Companies (VFA have published respectively recommendations dealing with quality aspects of non-interventional observational studies. Key points are the advanced publishing of information about the project, developing of a study plan/protocol containing the scientific objectives, a sample size justification and a description of the planned analyses and the publishing of a summary of the results timely after completion of the study. The quality of the data can be improved by using standardized case report forms (CRF and the CRF should be reviewed and tested before start of study by some participants. A source data verification (SDV should be performed in randomly selected centres – in between 2% and 5% of the centres depending on the number of participating centres
Patients’ attitudes and perceptions of two health-related quality-of-life questionnaires used to collect patient-reported outcome measures in the English National Health Service: A qualitative study of patients undergoing cardiac interventions
Bashir M Matata
Full Text Available Objectives: To explore patients’ views on the EuroQol-5D and Coronary Revascularisation Outcome Questionnaire, tools currently used for collecting patient-reported outcome measures in the English National Health Service. The key questions were as follows: (1 whether patients consider them sensitive enough to detect change in their health after cardiovascular disease interventions and (2 whether they consider the health-related quality-of-life questions as meaningful. Methods: Data were collected on patients’ views using focus groups. We held four focus groups selecting participants on the basis of their baseline and follow-up EuroQol-5D scores. Data were analysed using framework analysis and grounded theory. Results: Focus group participants confirmed that they had derived substantial health benefits from their cardiac interventions despite the lack of measurable effects on the EuroQol-5D scores. Participants felt that the EuroQol-5D questionnaire was limited because of the following reasons: Their health fluctuates from day to day. They had difficulty assessing their general health status on the visual analogue scale. They felt that the Coronary Revascularisation Outcome Questionnaire was limited because of the following reasons: They did not understand the clinical terms used. The impact of tiredness on their quality of life was not captured. They were unable to distinguish between the effects of their heart condition and other health issues. Additionally, neither questionnaire considers the adjustments people have made to their domestic arrangements to improve their health-related quality of life. Conclusion: This study provides evidence that the two questionnaires do not capture some aspects of health that patients consider important. Furthermore, the presence of co-morbidities masks the symptoms relating to the heart disease and the effect of their cardiac interventions. Future work on patient-reported outcome measures should consider
Rudall, Nicola; McKenzie, Catherine; Landa, June; Bourne, Richard S; Bates, Ian; Shulman, Rob
Clinical pharmacist (CP) interventions from the PROTECTED-UK cohort, a multi-site critical care interventions study, were further analysed to assess effects of: time on critical care, number of interventions, CP expertise and days of week, on impact of intervention and ultimately contribution to patient care. Intervention data were collected from 21 adult critical care units over 14 days. Interventions could be error, optimisation or consults, and were blind-coded to ensure consistency, prior to bivariate analysis. Pharmacy service demographics were further collated by investigator survey. Of the 20 758 prescriptions reviewed, 3375 interventions were made (intervention rate 16.1%). CPs spent 3.5 h per day (mean, ±SD 1.7) on direct patient care, reviewed 10.3 patients per day (±SD 4.2) and required 22.5 min (±SD 9.5) per review. Intervention rate had a moderate inverse correlation with the time the pharmacist spent on critical care (P = 0.05; r = 0.4). Optimisation rate had a strong inverse association with total number of prescriptions reviewed per day (P = 0.001; r = 0.7). A consultant CP had a moderate inverse correlation with number of errors identified (P = 0.008; r = 0.6). No correlation existed between the presence of electronic prescribing in critical care and any intervention rate. Few centres provided weekend services, although the intervention rate was significantly higher on weekends than weekdays. A CP is essential for safe and optimised patient medication therapy; an extended and developed pharmacy service is expected to reduce errors. CP services should be adequately staffed to enable adequate time for prescription review and maximal therapy optimisation. © 2016 Royal Pharmaceutical Society.
M. Chersich (Matthew); S. Luchters (Stanley); I. Ntaganira (Innocent); A. Gerbase (Antonio); Y-R. Lo (Ying-Ru); F. Scorgie (Fiona); R. Steen (Richard)
textabstractIntroduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for
Randomized, interventional, prospective, comparative study to evaluate the antihypertensive efficacy and tolerability of ramipril versus telmisartan in stage 1 hypertensive patients with diabetes mellitus.
Full Text Available Background: Mental health needs to increase in disasters and this study assesses the basic and mental health needs and delivered services during the first month after Bam (Iran earthquake disaster in year 2004."nMethods: Thirty Five mental health professionals and experts were involved in mental health care and interventions for survivors in Tehran general hospitals and in the Bam, were participated in a focus group qualitative study, and finding analyzed after coding from tape recorder."nResults: The primary and immediate needs of survivors were: water, food, shelter, security, finding family members, treating and helping injured ones, respect and good relationship by others, and information and news about disaster and others. Second and long time needs and services were the previous needs and services and also immediate starting the daily routine activities, opening schools and workplaces, participating in community services and resettlement or housing. Lack of previous program and inadequate services are discussed in the paper."nConclusion: It is the first time in Iran survivors get immediate mental health intervention in disaster, but based on finding and the survivors needs, and the problems reported in services were delivered, the study proposes a new mental health intervention program in natural disaster for Iran
Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I
Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Ferguson, Kristin M.; Xie, Bin
Objective: To reduce mental health symptoms and high-risk behaviors and increase social support and service utilization among street-living youth, the authors conducted a pilot study to assess the feasibility of the social enterprise intervention (SEI) at a homeless youth agency. Method: Convenience sampling was used to recruit 16 street-living…
Popp, Tierney K.; You, Hyun-Kyung
The mediating role of parental satisfaction in the relation between family involvement in early intervention service planning and parental self-efficacy was explored. Participants included families of children with disability or delay involved in early intervention (n = 2586). Data were examined upon entry into early intervention (T1) and at…
Cheng, Jui-Fen; Huang, Xuan-Yi; Lin, Mei-Jue; Wang, Ya-Hui; Yeh, Tzu-Pei
To investigate a community-based and hospital-based home visit partnership intervention in improving caregivers' satisfaction with home service and reducing caregiver burden. The community-oriented mental healthcare model prevails internationally. After patients return to the community, family caregivers are the patients' main support system and they also take the most of the burden of caring for patients. It is important to assist these caregivers by building good community healthcare models. A longitudinal quasi-experimental quantitative design. The experimental group (n = 109) involved "partnership" intervention, and the control group (n = 101) maintained routine home visits. The results were measured before the intervention, 6 and 12 months after the partnership intervention. Six months after the partnership intervention, the satisfaction of the experimental group was higher than the control group for several aspects of care. Although the care burden was reduced in the experimental group, there was no significant difference between the two groups. This study confirms that the partnership intervention can significantly improve caregiver satisfaction with home services, without reducing the care burden. The community-based and hospital-based mental health home visit service partnership programme could improve the main caregiver's satisfaction with the mental health home visit services, while the reduction in care burden may need government policies for the provision of more individual and comprehensive assistance. © 2017 John Wiley & Sons Ltd.
Full Text Available Abstract Background UK NHS Stop Smoking Services provide cost effective smoking cessation interventions but, as yet, there has been no assessment of their provision of relapse prevention interventions. Methods Electronic questionnaire survey of 185 UK Stop Smoking Services Managers. Results Ninety six Stop Smoking Service managers returned completed questionnaires (52% response rate. Of these, 58.3% (n = 56 ran NHS Stop Smoking Services which provided relapse prevention interventions for clients with the most commonly provided interventions being behavioural support: telephone (77%, group (73%, and individual (54%. Just under half (48%, n = 27 offered nicotine replacement therapy (NRT, 21.4% (n = 12 bupropion; 19.6% (n = 11 varenicline. Over 80% of those providing relapse prevention interventions do so for over six months. Nearly two thirds of all respondents thought it was likely that they would either continue to provide or commence provision of relapse prevention interventions in their services. Of the remaining respondents, 66.7% (n = 22 believed that the government focus on four-week quit rates, and 42.9% (14 services believed that inadequate funding for provision of relapse prevention interventions, were major barriers to introducing these interventions into routine care. Conclusions Just over half of UK managers of NHS Stop Smoking Services who responded to the questionnaire reported that, in their services, relapse prevention interventions were currently provided for clients, despite, at that time, there being a weak evidence base for their effectiveness. The most commonly provided relapse prevention interventions were those for which there was least evidence. If these interventions are found to be effective, barriers would need to be removed before they would become part of routine care.
Farag, I; Howard, K; O'Rourke, S; Ferreira, M L; Lord, S R; Close, J C T; Vogler, C; Dean, C M; Cumming, R G; Sherrington, C
Admission to hospital can lead to persistent deterioration in physical functioning, particularly for the more vulnerable older population. As a result of this physical deterioration, older people who have been recently discharged from hospital may be particularly high users of health and social support services. Quantify usage and costs of services in older adults after hospitalisation and explore the impact of a home-exercise intervention on service usage. The present study was a secondary analysis of data from a randomised controlled trial (ACTRN12607000563460). The trial involved 340 participants aged 60 years and over with recent hospitalisation. Service use and costs were compared between intervention (12 months of home-exercise prescribed in 10 visits from a physiotherapist) and control groups. 33 % of participants were re-admitted to hospital, 100 % consulted a General Medical Practitioner and 63 % used social services. 56 % of costs were associated with hospital admission and 22 % with social services. There was reduction in General Medical Practitioner services provided in the home in the intervention group (IRR 0.23, CI 0.1 to 0.545, p home-based exercise program was evident on service use or costs. Australian and New Zealand Clinical Trial Registry ACTRN12607000563460 >TrialSearch.
Ziviani, Jenny; Cuskelly, Monica; Feeney, Rachel
Measuring parent satisfaction with services is essential in the evaluation of early intervention programs. However, there is a paucity of satisfaction measures specifically developed for this purpose, and the psychometric properties of existing measures have not been widely examined. The aim of this study was to further investigate the internal…
Pérez Fernández, María Reyes; Almazán Ortega, Raquel; Martínez Portela, José María; Alves Pérez, M Teresa; Segura Iglesias, M Carmen; Pérez Fernández, Román
The aim of this study is to determine whether an educational intervention in perimenopausal women in rural environments achieves significant changes in risk behaviors related to osteoporosis. Randomized clinical trials of parallel groups: 216 women (45-54 years old) of a rural Primary Healthcare service. Pre- and post- intervention were covered: body mass index (BMI), densitometry and blood test (calcium [Ca], parathormone [PTH]). Intervention group (n1=110): 2 interactive workshops on the prevention of osteoporosis. Control group (n2=106): information by post. After the educational intervention, the intervention group maintained its BMI, increased its bone mineral density (BMD) (P<.001) and decreased the Ca (P ≤.048) and PTH (P<.001) levels. The control group increased its BMI (P<.001) and its BMD (P ≤.048), maintained its Ca levels and decreased the PTH values (P=.01). The improvement in the objective parameters related to osteoporosis indicates the importance of health education as a preventive measure in this group of women. It would be interesting to analyze the repercussions of this improvement on a long-term basis in terms of reducing the incidence of osteoporosis and fractures. Copyright © 2012 Elsevier España, S.L. All rights reserved.
Weiler, Monica R; Lavender, Steven A; Crawford, J Mac; Reichelt, Paul A; Conrad, Karen M; Browne, Michael W
This study explored factors contributing to intervention adoption decisions among Emergency Medical Service (EMS) workers. Emergency Medical Service workers (n = 190), from six different organisations, participated in a two-month longitudinal study following the introduction of a patient transfer-board (also known as slide-board) designed to ease lateral transfers of patients to and from ambulance cots. Surveys administered at baseline, after one month and after two months sampled factors potentially influencing the EMS providers' decision process. 'Ergonomics Advantage' and 'Patient Advantage' entered into a stepwise regression model predicting 'intention to use' at the end of month one (R (2 )= 0.78). After the second month, the stepwise regression indicated only two factors were predictive of intention to use: 'Ergonomics Advantage,' and 'Endorsed by Champions' (R (2 )= 0.58). Actual use was predicted by: 'Ergonomics Advantage' and 'Previous Tool Experience.' These results relate to key concepts identified in the diffusion of innovation literature and have the potential to further ergonomics intervention adoption efforts. Practitioner Summary. This study explored factors that potentially facilitate the adoption of voluntarily used ergonomics interventions. EMS workers were provided with foldable transfer-boards (slideboards) designed to reduce the physical demands when laterally transferring patients. Factors predictive of adoption measures included perceived ergonomics advantage, the endorsement by champions, and prior tool experience.
Kelso, Ginger L.; Fiechtl, Barbara J.; Olsen, Susan T.; Rule, Sarah
Although videoconferencing has been used to deliver distance education, tutoring for children, and telemedicine observations, there is limited information on the efficacy of its use in delivering part C early intervention services. Four families receiving early intervention services in a rural program participated in a pilot study to test the…
... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One...
Testing the effectiveness of a motivational interviewing-based brief intervention for substance use as an adjunct to usual care in community-based AIDS service organizations: study protocol for a multisite randomized controlled trial
Bryan R. Garner
Full Text Available Abstract Background In 2010, the first comprehensive National HIV/AIDS Strategy for the United States was released and included three goals: (1 reducing the number of people who become infected with HIV, (2 increasing access to care and improving health outcomes for people living with HIV, and (3 reducing HIV-related health disparities and health inequities. In 2013, as part of its effort to help address the National HIV/AIDS Strategy, the National Institute on Drug Abuse (NIDA funded a type 2 effectiveness-implementation hybrid trial titled the Substance Abuse Treatment to HIV Care (SAT2HIV Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI for substance use as an adjunct to usual care within AIDS Service Organizations (ASOs as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF as an adjunct to the Addiction Technology Transfer Center (ATTC model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Methods As part of a multisite randomized controlled trial, individuals with comorbid HIV/AIDS and problematic substance use are randomized to receive either the ASOs’ usual care (control condition or usual care plus a MIBI for substance use (experimental condition delivered by trained ASO case-management staff. Primary outcome measures are reductions in days of primary substance use, number of substance-related problems, times engaging in risky behaviors, days of non-adherence to HIV medications, and increases in substance use treatment. As part of this paper, we describe the trial protocol in accordance with the Standard Protocol Items: Recommendations for Interventional Trials guidelines. Discussion If successfully able to implement MIBI as an effective adjunct to usual care, the current trial may
There is growing interest in valuing ecosystem services provided by marsh systems. Ecosystem services represent a flow of benefits to society from the existence or functioning of the marsh. Therefore, to “put a value on” the marsh itself, or estimate a value of the na...
A qualitative investigation into nurses' perceptions of factors influencing staff injuries sustained during physical interventions employed in response to service user violence within one secure learning disability service.
Lovell, Andrew; Smith, Debra; Johnson, Paula
The aim of the study was to examine learning disability nurses' perceptions of incidents involving physical intervention, particularly factors contributing to injuries sustained by this group. This article reports on a qualitative study undertaken within one secure NHS Trust to respond to concerns about staff injuries sustained during physical interventions to prevent incidents of service user violence from escalating out of control. The context of the study relates to increasing debate about the most effective approaches to incidents of violence and agression. A qualitative research design was utilized for the study. Semi-structured interviews were undertaken with 20 participants, two from each of the 10 incidents involving staff injury sustained during physical intervention. Four themes were produced by the analysis, the first, knowledge and understanding, contextualized the other three, which related to the physical intervention techniques employed, the interpretation of the incident and the impact on staff. Service user violence consistently poses nurses with the challenge of balancing the need to respond in order to maintain the safety of everyone whilst simultaneous supporting and caring for people with complex needs. This study highlights the need for further exploration of the contributory factors to the escalation of potentially violent situations. Services may have good systems in place for responding to and managing service user violence but appear less effective in understanding the reasons for and developing strategies to prevent violence occurring. © 2015 John Wiley & Sons Ltd.
The past decade has witnessed revolutionary changes to the delivery of health services, ushered in to a great extent by the introduction of electronic health record systems. More recently, a new class of technological advancements-technology-based behavioral health interventions, which involve the delivery of evidence-informed practices via computers, web-based applications, mobile phones, wearable sensors, or other technological platforms-has emerged and is primed to once again radically shift current models for behavioral healthcare. Despite the promise and potential of these new therapeutic approaches, a greater understanding of the impact of technology-based interventions on cornerstone issues of mental health and addiction services-namely access, quality, and cost-is needed. The current review highlights 1) relevant conceptual frameworks that guide this area of research, 2) key studies that inform the relevance of technology-based interventions for behavioral healthcare access, quality, and cost, 3) pressing methodological issues that require attention, 4) unresolved questions that warrant further investigation, and 5) practical implications that underscore important new directions for this emerging area of research.
Alotaibi, Faihan; Almalki, Nabil
The present study sought to examine parents' perceptions of early interventions and related services for children with autism spectrum disorder (ASD) in Saudi Arabia. In this study a survey was distributed to a sample of 80 parents with children who have ASD. Parents also were asked open-ended questions to enable them to provide suggestions. The…
Pirrallo, Ronald G; Cady, Charles E
The authors conducted a pilot study, finding that many households that experienced fires had received prior emergency medical services (EMS) visits, but few had operational smoke alarms. The study hypothesis is that dwellings that received smoke alarms and/or batteries during an EMS call were more likely to have an operational alarm, less property dollar loss, and decreased morbidity and mortality at the time of a subsequent fire. Smoke detectors and batteries were provided to an urban fire department for placement in unprotected homes at the time of an EMS call from March 1, 1999, through January 31, 2001. After addressing the reason for the 911 EMS call, verification or installation of an operational smoke alarm was performed. The authors examined records for dwellings that had a subsequent fire for outcomes of smoke alarm status, estimated property dollar loss, and number of injuries and fatalities. This program placed 1,335 smoke detectors. Of these, 99 dwellings were found to have a fire or smoke condition with 20 exclusions. Our final number was 79; 28 (35%) still had an operating smoke alarm. In homes with operational alarms, the mean dollar loss was 2,870 dollars (U.S. 2001) (95% confidence interval [CI], 143-5,596). In homes without operational alarms, mean loss was 10,468 dollars (U.S. 2001) (95% CI, 5,875-15,061). No injuries or fatalities occurred in either group. This program was successful in placing 1,335 smoke alarms in at-risk dwellings and reaffirmed that an operational smoke alarm significantly decreases property dollar loss. However, if the goal is to have all homes protected by smoke alarms, this program has long-term effectiveness limitations.
Full Text Available The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services. Keywords: Telerehabilitation, Occupational Therapy, Rural, Early Intervention, Children, Program Evaluation, Cost Analysis
... 29 Labor 1 2010-07-01 2010-07-01 true Contents of requests; service on other parties; answer; intervention. 25.4 Section 25.4 Labor Office of the Secretary of Labor RULES FOR THE NOMINATION OF ARBITRATORS...; intervention. (a) Requests for nominations 1 shall be in triplicate and contain the following information: 1...
Ely, Mindy S.; Gullifor, Kateri; Hollinshead, Tara
Early intervention visual impairment services are built on a model that values family. Matrix session planning pulls together parent priorities, family routines, and identified strategies in a way that helps families and early intervention professionals outline a plan that can both highlight long-term goals and focus on what can be done today.…
Moxley, David P; Calligan, Holly Feen
The arts have been integral to the human experience fostering innovation in social arrangements, strengthening group cohesion, and merging esthetics with the utilitarian properties of technology. For intervention design research in the human services the arts can harness innovation and creativity in meeting human needs and addressing social issues. Given their capacities to stimulate expression of first person experience through interpretative strategies, the arts can equip people and groups, including researchers, with opportunities to express primary experiential knowledge through creative means, portray useful ways of meeting human needs, educate others about the social issues people experience, and formulate intervention strategies or even models to address the causes and consequences of those issues. In this paper, the authors discuss how the arts can inform and deepen human service intervention design and development and, as a result, advance innovation in the human services. They offer a rationale supporting the inclusion of the arts in the design of human service interventions, examine the contributions of the arts to the formulation of intervention concept and developmental research to further improve interventions, and consider how the arts can advance the reflexivity of intervention designers. The authors draw implications for how researchers can position the arts in the nine steps of intervention design and development the authors offer in this paper. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gender Differences in Service Utilization among OEF/OIF Veterans with Posttraumatic Stress Disorder after a Brief Cognitive-Behavioral Intervention to Increase Treatment Engagement: A Mixed Methods Study.
Gallegos, Autumn M; Wolff, Kristina B; Streltzov, Nicholas A; Adams, Leslie B; Carpenter-Song, Elizabeth; Nicholson, Joanne; Stecker, Tracy
Women veterans who served in Iraq and Afghanistan (Operation Enduring Freedom and Operation Iraqi Freedom [OEF/OIF]) have a moderately higher risk of developing posttraumatic stress disorder (PTSD) than male veterans. However, gender disparities in treatment engagement may prevent women veterans from initiating the care they need. Understanding gender differences in predictors of and barriers to treatment is essential to improving engagement and mental health outcomes. The purpose of this study was to examine gender differences in treatment utilization after a brief, cognitive-behavioral therapy (CBT) intervention among male and female OEF/OIF veterans. Participants were assigned randomly to either the intervention or control conditions. Intervention participants received the telephone-based CBT intervention. Participants were 35 female and 238 male OEF/OIF veterans who screened positive for PTSD and had never initiated PTSD treatment. Participants were asked about treatment utilization, beliefs about PTSD treatment, and symptoms at months 1, 3, and 6 months subsequent to the baseline telephone assessment. The PTSD Checklist-Military Version was used to assess PTSD and the Patient's Health Questionnaire was used to assess symptoms of depression. Female veterans who received an intervention were significantly more likely to have attended treatment over the 6-month follow-up period than male veterans who received an intervention (χ(2) = 7.91; df = 3; odds ratio, 3.93; p = .04). The CBT intervention may be a critical mechanism to engage female veterans in treatment. Further research is needed to understand how to engage male veterans with PTSD in treatment. Copyright © 2015 Jacobs Institute of Women's Health. All rights reserved.
Maria V. Ciasullo
Full Text Available In the service economy, scholars and practitioners are even more focused on the development and appliance of innovative services. The importance of service innovation is rising in many sectors and among different organizations. Several disciplines (e.g., marketing, management, operations research, etc. deal with this innovation, a concept widely used, but with different definitions. In this paper, service innovation has been analyzed according to the Service Dominant Logic (S-D Logic and a service ecosystem perspective. The literature still calls for a greater understanding of how a new or renewed combination of resources affects the shaping of service ecosystems. To contribute to filling this gap, this study explores the practices that different actors, enact to co-create value in novel ways; i.e., service innovation. The paper is structured as follows. In the first section, the main academic contributions on service research have been reviewed, focusing on healthcare service innovation. This is followed by the research method and discussion of the research findings. Finally, the theoretical and managerial implications have been detailed and an agenda for future research suggested. The paper offers interesting insights to develop new or renewed practices that foster the reshaping and maintaining of a healthcare service ecosystem. Some recommendations are included to support managers in the development of service innovation strategies.
Grogan-Johnson, Sue; Schmidt, Anna Marie; Schenker, Jason; Alvares, Robin; Rowan, Lynne E.; Taylor, Jacquelyn
Telepractice has the potential to provide greater access to speech-language intervention services for children with communication impairments. Substantiation of this delivery model is necessary for telepractice to become an accepted alternative delivery model. This study investigated the progress made by school-age children with speech sound…
Kieran M. Killeen
Full Text Available As states have become more active in establishing curriculum content standards and related assessments disappointingly little attention has been paid to policy efforts that create learning opportunities for students to meet the new standards. This study examines one state policy designed to bolster the opportunity to learn by mandating additional instruction for students not currently achieving proficiency in the state standards. The results focus on a detailed description of New York State's Academic Intervention Services, including its organizational and instructional elements (e.g., staffing, scheduling, student grouping, instructional strategies across NYS schools. While the majority of states have established curriculum frameworks and linked them to assessment instruments, this experience in NY may be unique for its coordinated emphasis on intervention services (academic and non-academic linked to rigorous learning and accountability standards. However, the caveats identified in this study promote a familiar sense of local discretion in the interpretation and implementation of state policy mandates. The analyses describe how such practices vary by local district context, such as community wealth and geography, and if those practices have equity implications. The primary analyses draw on survey data from a stratified random sample of 764 teachers and principals from 125 school districts, and feature multi-variate methods with proper adjustment for the clustering of responses within districts (i.e., multiple teachers and administrators within each district.
The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/str...
Martinez, Kathryn A; Friese, Christopher; Kershaw, Trace; Given, Charles W; Fendrick, A Mark; Northouse, Laurel
To examine differences in healthcare service utilization among patients with advanced cancer participating in a nurse-led psychoeducational intervention. Secondary analysis of trial data. Four Michigan cancer centers. 484 patients with advanced cancer. Patients were randomized to three groups. Study arm (brief, extensive, or control), ED visitation (one or more times versus none), inpatient hospitalizations (one or more times versus none), and covariates. No significant differences in ED visits or inpatient hospitalizations were observed among study arms. ED visits were more frequent for patients with lung or colorectal cancer, more comorbidities, and lower baseline QOL. Baseline QOL was associated with inpatient hospitalizations in the adjusted analysis. The psychoeducational intervention, either in brief or extensive format, is unlikely to increase healthcare service utilization. Efficacious nurse-led psychoeducational interventions to improve QOL do not place undue burdens on the healthcare system and may improve care.
Background Integration of human immunodeficiency virus (HIV) care into primary care services is one strategy proposed to achieve universal access to antiretroviral treatment (ART) for HIV-positive patients in high burden countries. There is a need for controlled studies of programmes to integrate HIV care with details of the services being integrated. Methods A semi-quantitative questionnaire was developed in consultation with clinic staff, tested for internal consistency using Cronbach's alpha coefficients and checked for inter-observer reliability. It was used to conduct four assessments of the integration of HIV care into referring primary care clinics (mainstreaming HIV) and into the work of all nurses within ART clinics (internal integration) and the integration of pre-ART and ART care during the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) trial in South Africa. Mean total integration and four component integration scores at intervention and control clinics were compared using one way analysis of variance (ANOVA). Repeated measures ANOVA was used to analyse changes in scores during the trial. Results Cronbach's alpha coefficients for total integration, pre-ART and ART integration and mainstreaming HIV and internal integration scores showed good internal consistency. Mean total integration, mainstreaming HIV and ART integration scores increased significantly at intervention clinics by the third assessment. Mean pre-ART integration scores were almost maximal at the first assessment and showed no further change. There was no change in mean internal integration score. Conclusion The questionnaire developed in this study is a valid tool with potential for monitoring integration of HIV care in other settings. The STRETCH trial interventions resulted in increased integration of HIV care, particularly ART care, by providing HIV care at referring primary care clinics, but had no effect on integrating HIV care into the work of all nurses
Connecticut Birth to Three System, Hartford.
This guide was developed to assist families and service providers in Connecticut with nutrition services for infants and toddlers with disabilities. Individual sections provide information about the following topics: laws and regulations related to nutrition services; eligibility for the Connecticut Birth to Three System and nutrition; nutrition…
Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne
Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers' ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. EMS: Emergency medical services; SIRI: Suicide intervention response inventory.
Scupola, Ada; Nicolajsen, Hanne Westh
University Library (RUB). The conclusion of this research is that both external environmental factors and internal organizational factors are important factors in adoption of e-services at Roskilde University Library. However the study shows that external factors such as government intervention...... and technological development might have been having a more important role than other external factors and that top management might have more influence on radical e-services adoption than other factors in the organizational context....
Bhutta, Zulfiqar A; Darmstadt, Gary L; Haws, Rachel A; Yakoob, Mohammad Yawar; Lawn, Joy E
Background Although a number of antenatal and intrapartum interventions have shown some evidence of impact on stillbirth incidence, much confusion surrounds ideal strategies for delivering these interventions within health systems, particularly in low-/middle-income countries where 98% of the world's stillbirths occur. Improving the uptake of quality antenatal and intrapartum care is critical for evidence-based interventions to generate an impact at the population level. This concluding paper of a series of papers reviewing the evidence for stillbirth interventions examines the evidence for community and health systems approaches to improve uptake and quality of antenatal and intrapartum care, and synthesises programme and policy recommendations for how best to deliver evidence-based interventions at community and facility levels, across the continuum of care, to reduce stillbirths. Methods We systematically searched PubMed and the Cochrane Library for abstracts pertaining to community-based and health-systems strategies to increase uptake and quality of antenatal and intrapartum care services. We also sought abstracts which reported impact on stillbirths or perinatal mortality. Searches used multiple combinations of broad and specific search terms and prioritised rigorous randomised controlled trials and meta-analyses where available. Wherever eligible randomised controlled trials were identified after a Cochrane review had been published, we conducted new meta-analyses based on the original Cochrane criteria. Results In low-resource settings, cost, distance and the time needed to access care are major barriers for effective uptake of antenatal and particularly intrapartum services. A number of innovative strategies to surmount cost, distance, and time barriers to accessing care were identified and evaluated; of these, community financial incentives, loan/insurance schemes, and maternity waiting homes seem promising, but few studies have reported or evaluated the
Radhakrishnan, Muralikrishnan; McCrone, Paul; Lafortune, Louise; Everard, Linda; Fowler, David; Amos, Tim; Freemantle, Nick; Singh, Swaran P; Marshall, Max; Sharma, Vimal; Lavis, Anna; Jones, Peter B; Birchwood, Max
Early intervention services (EIS) for psychosis are being implemented, internationally. It is important to learn from established examples and define the components and intensity of services that provide good value for money. This study aims to assess the cost-effectiveness of EIS according to how closely they adhered to the recommendations of the English Department of Health 2001 Policy Implementation Guide (PIG). EIS from the National Eden Study were assessed using a measure of fidelity to the PIG that rated the presence or absence of 64 recommended items relating to team structure and practice. EIS were then classified into three groups: those with fidelity of 75-80%, 81-90% and 91-95%. Patient-level resource use and outcomes were measured 1 year following inception into the service; costs were calculated and combined with quality-adjusted life years (QALYs) gained. At a threshold of £20 000 per QALY, the 81-90% fidelity group had a 56.3% likelihood of being the most cost-effective option followed by 75-80% fidelity at 35.8% and 91-95% fidelity group (7.9%). The results from England suggest that striving to maximize fidelity may not be warranted, but that dropping below a certain level of fidelity may result in inefficient use of resources. © 2017 John Wiley & Sons Australia, Ltd.
The purpose of this paper is to emphasize the importance of early intervention. The purpose of early intervention in Taipei City is to help child development, promote parenting skills, and reduce educational and social costs. In order to meet these goals, parenting groups and Taipei City Council have made great efforts to make early intervention work in Taipei City. In April 1995, Taipei City Government started planning and setting up the service network. To date, Taipei City has set up one reporting and referral center?, ?six community resources centers, 22 medical assessment and intervention clinics, 12 child development centers, one early intervention training center, three non-profit foundations and more than 300 inclusion schools, such as kindergartens and day care centers. With parent participation, professional devotion and Taipei City Government's commitment, the number of assisted children has increased from 98 to 2,523 /year. By the end of 2006, Taipei had already funded 25,277 children. We estimate Taipei City early intervention services to have affected at least 75,000 persons, including development-delayed and disabled children, their parents?, ?grandparents and siblings. We found that early intervention services help the children to build up self esteem, grow their potential, learn how to socialize, and receive an education, while the most important aim is to help them to reduce their level of disability or to prevent them from getting worse. At the same time, their families get support and a diverse range of services. An integrated early intervention program should include children, families, and multidisciplinary professionals. The system should therefore be more "family-centered" and "community-oriented" to provide appropriate services to children and families through a positive and aggressive attitude.
The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services. PMID:25945160
The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services.
Full Text Available Abstract Background There has been a considerable increase in the need for psychiatric services for adolescents. Primary health care practitioners have a major role in detecting, screening and helping these adolescents. An intervention entitled SCREEN is described in this article. The SCREEN intervention was developed to help practitioners to detect and screen adolescent needs, to care for adolescents at the primary health care level and to facilitate the referral of adolescents to secondary care services in collaboration between primary and secondary health care. Secondly, the article presents the background and clinical characteristics of youths seeking help from the SCREEN services, and compares the background factors and clinical characteristics of those patients referred and not referred to secondary care services. Methods The SCREEN intervention consisted of 1 to 5 sessions, including assessment by a semi-structured anamnesis interview, the structured Global Assessment Scale, and by a structured priority rating scale, as well as a brief intervention for each adolescent's chosen problem. Parents took part in the assessment in 39% of cases involving girls and 50% involving boys. During 34 months, 2071 adolescents (69% females entered the intervention and 70% completed it. The mean age was 17.1 years for boys and 17.3 years for girls. Results For 69% of adolescents, this was the first contact with psychiatric services. The most common reasons for seeking services were depressive symptoms (31%. Self-harming behaviour had occurred in 25% of girls and 16% of boys. The intervention was sufficient for 37% of those who completed it. Psychosocial functioning improved during the intervention. Factors associated with referral for further treatment were female gender, anxiety as the main complaint, previous psychiatric treatment, self-harming behaviour, a previous need for child welfare services, poor psychosocial functioning and a high score in the
Jones, Eleri; Lattof, Samantha R; Coast, Ernestina
The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their
Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard
Introduction Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. Results We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers’ access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers’ control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services – including peer interventions, condom promotion and STI screening – would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are
Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard
Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers' access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers' control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services - including peer interventions, condom promotion and STI screening - would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are required to enhance access to HIV testing and ART for
Matthew F Chersich
Full Text Available Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed and non-indexed journals were searched for studies with quantitative study outcomes. Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers’ access to care and antiretroviral treatment (ART, but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers’ control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions: There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services – including peer interventions, condom promotion and STI screening – would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers
... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS Program...
... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS Program...
... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS Program...
... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services. ACTION: Notice of Ryan White HIV/AIDS Program...
Zealley, I A; Gordon, T J; Robertson, I; Moss, J G; Gillespie, I N
To evaluate the availability of out-of-hours (OOH) interventional radiology (IR) services in Scotland and discuss implications for service redesign. Data were gathered via a survey conducted by telephone/e-mail interview. The setting was hospitals in Scotland with acute medical and/or surgical beds. The interviewees were consultant interventional radiologists representing each of the 14 geographical Health Boards in Scotland. Three of the 14 geographical Health Boards provided a formal, prospectively planned OOH IR service in at least one hospital. Fourteen of the 34 acute hospitals provided an in-hours IR service, which includes endovascular haemorrhage control. Eight of the 34 acute hospitals had formal, prospectively planned on-call IR arrangements, 12 had an ad-hoc service, and 20 transferred patients to other facilities. Thirty-eight of the 223 consultant radiologists in Scotland were able to perform endovascular haemorrhage control procedures: only 18 of these 38 (47%) were included in on-call rotas. A further 42 radiologists were able to perform nephrostomy and a further 61 were able to perform abscess drainage. Eighty-two radiologists did not perform any interventional procedures. The provision of OOH IR services in Scotland is limited and available resources, both skills and equipment, are being underutilized. These data will be used to inform a process of OOH IR service redesign in Scotland. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Begotti, Tatiana; Tirassa, Maurizio; Acquadro Maran, Daniela
We compared the respective attitudes of pre-service teachers (PST) and in-service teachers (IST) towards bullying. A questionnaire survey was administered to 110 PST and 128 IST. Self-efficacy beliefs, external locus of causality and empathy for the victims were higher in IST than PST. Perceived seriousness of bullying and likelihood of…
Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne
ABSTRACT Background: Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. Aims: To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Method: Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey asses...
... White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive... care services for persons living with HIV/AIDS, HRSA will provide a one-time noncompetitive Ryan White...
Venkataraman, Shruthi; Jordan, Gerald; Pope, Megan A; Iyer, Srividya N
To better understand cultural competence in early intervention for psychosis, we compared service users' and service providers' perceptions of the importance of providers being culturally competent and attentive to aspects of culture. At a Canadian early intervention programme, a validated scale was adapted to assess service user (N = 51) and provider (N = 30) perceptions of service providers' cultural competence and the importance accorded thereto. Analyses of variance revealed that the importance of service providers being culturally competent was rated highest by service providers, followed by visible minority service users, followed by white service users. Providers rated themselves as being more interested in knowing about service users' culture than service users perceived them to be. Service users accorded less import to service providers' cultural competence than providers themselves, owing possibly to varied socialization. A mismatch in users' and providers' views on providers' efforts to know their users' cultures may influence mental healthcare outcomes. © 2017 John Wiley & Sons Australia, Ltd.
Banerjee, Sushanta K; Andersen, Kathryn L; Buchanan, Rebecca M; Warvadekar, Janardan
Unsafe abortion in India leads to significant morbidity and mortality. Abortion has been legal in India since 1971, and the availability of safe abortion services has increased. However, service availability has not led to a significant reduction in unsafe abortion. This study aimed to understand the gap between safe abortion availability and use of services in Bihar and Jharkhand, India by examining accessibility from the perspective of rural, Indian women. Two-stage stratified random sampling was used to identify and enroll 1411 married women of reproductive age in four rural districts in Bihar and Jharkhand, India. Data were collected on women's socio-demographic characteristics; exposure to mass media and other information sources; and abortion-related knowledge, perceptions and practices. Multiple linear regression models were used to explore the association between knowledge and perceptions about abortion. Most women were poor, had never attended school, and had limited exposure to mass media. Instead, they relied on community health workers, family and friends for health information. Women who had knowledge about abortion, such as knowing an abortion method, were more likely to perceive that services are available (β = 0.079; p influencers may also counteract negative social norms regarding abortion and associated stigma. Collaborative actions of government, NGOs and private partners should capitalize on this potential power of communities to reduce the impact of unsafe abortion on rural women.
Patterson Silver Wolf Adelv Unegv Waya, David A
Although alcohol use continues to be a major problem, when high-risk users enter social services, they are not provided with empirically supported treatments (ESTs). This study investigates predictors of successful implementation in agencies not specializing in addiction services. Fifty-four frontline workers in six organizations were enrolled in the study. After completing self-administered surveys of organizational culture and climate and attitudes toward ESTs, workers were trained to implement a brief intervention. The results indicate that organizational factors and attitudes may not be related to implementation. Although high implementers had similar traits, further research is needed to characterize successful EST implementers.
It is not knowledge-for-its-own-sake, but the knowledge is valued because it contributes to the improvement of the practice which is considered (by ministers and lay people) to be a problem. Practice-orientated research is especially relevant to congregational studies because the congregational ministry is conducted within ...
Allison, Douglas; Barry, Kevin; Beaver, Philip; Browne, Michael; Cubillos, Claudio; Hanger, Wallace; Kluchko, Luke; LaDue, Charles; McGhee, Michael; Mitsoff, Gregory
.... The industry includes those firms that provide financial services to organizations or individuals, the government agencies that regulate the industry, and the markets that facilitate the exchange of financial assets...
Schilling, Sara; Bustamante, Juan Antonio; Sala, Andres; Acevedo, Claudio; Tapia, Eric; Alvarado, Ruben; Sapag, Jaime C; Yang, Lawrence Hsin; Lukens, Ellen; Mascayano, Franco; Cid, Patricia; Tapia, Thamara
Latin America is characterized by a high prevalence of public stigma toward those with mental illness, and significant selfstigma among labeled individuals, leading to social exclusion, low treatment adherence, and diminished quality of life. However, there is no published evidence of an intervention designed to address stigma in the region. In light of this, a psychosocial intervention to reduce self-stigma among users with severe mental illness was developed and tested through an RCT in two regions of Chile. To describe the development of the psychosocial intervention, assess its feasibility and acceptability, and evaluate its preliminary impact. An intervention was designed and is being tested, with 80 users with severe mental illness attending two community mental health outpatient centers. To prepare the intervention, pertinent literature was reviewed, and experts and mental health services users were consulted. Feasibility and acceptability were assessed, and impact was analyzed, based on follow-up qualitative reports by the participants. The recovery-oriented, ten-session group intervention incorporates the Tree of Life narrative approach, along with other narrative practices, to promote a positive identity change in users, and constructivist psychoeducation, based on case studies and group discussions, to gather tools to confront self-stigma. The intervention was feasible to implement and well evaluated by participants, family members, and center professionals. Participants reported increased self-confidence, and the active use of anti-stigma strategies developed during the workshop. This group intervention promises an effective means to reduce stigma of mental illness within Chile and other Latin American countries and feasibility to scale up within mental health services.
Sarmento, Teresa; Patrício, Lia; Bártolo, José
This paper presents the results of an exploratory study on the relevance of experiential factors when using services. The multidisciplinary approach is stressed seeing that is an important contribution in terms of service design interfaces. The project aimed at identifying elements for designing service experiences and for contributing to an improved service design and testing process. The paper presents a study carried out on a group of participants in a creative training cour...
Burnell, Karen J; Selwood, Amber; Sullivan, Theresa; Charlesworth, Georgina M; Poland, Fiona; Orrell, Martin
Involving service users in research can be an effective way of improving the practicalities and acceptability of interventions for target end users. The current paper presented two consensus methods, not commonly used in consultation with service users, to develop a peer support intervention for family carers of people with dementia (SHIELD Carer Supporter Programme). Study 1 was a modified Delphi process combined with a consensus conference to explore details of the intervention from the carer and volunteer perspective. Study 2 was an anonymous reader consultation to develop informed consent documents for the intervention trial. Median scores were used to measure and establish consensus. Open-ended responses were thematically analysed. Study 1: twenty-five delegates participated (eight were current/former carers) in the first round Delphi questionnaire, with 21 attending the conference. Five completed the Round 2 questionnaire. Study 2: six family carers and 11 people with dementia took part in the consultation. Study 1: the role of the peer supporters was developed in terms of relational and practical aspects of the intervention. Study 2: changes were made to the documents, reflecting service user input, but the effectiveness of this less discursive type of service user involvement was unclear. Study 1 methods allowed for service users to contribute significantly and meaningfully, but maybe limiting some design innovation. Study 2 took a more traditional and less collaborative approach. This has implications for balancing the needs of the research with meaningful service user involvement in research. © 2012 John Wiley & Sons Ltd.
... toddler's present levels of physical development, cognitive development, communication development, social... other family members will accept or decline any early intervention service without jeopardizing the...
Arving, Cecilia; Thormodsen, Inger; Brekke, Guri; Mella, Olav; Berntsen, Sveinung; Nordin, Karin
Faced with a life-threatening illness, such as cancer, many patients develop stress symptoms, i.e. avoidance behaviour, intrusive thoughts and worry. Stress management interventions have proven to be effective; however, they are mostly performed in group settings and it is commonly breast cancer patients who are studied. We hereby present the design of a randomized controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of an individual stress-management intervention with a stepped-care approach in several cancer diagnoses. Patients (≥ 18 years) with a recent diagnosis of breast cancer, colorectal cancer, lymphoma, prostate cancer or testicle cancer and scheduled for adjuvant/curative oncology treatment, will consecutively be included in the study. In this prospective longitudinal intervention study with a stepped-care approach, patients will be randomized to control, treatment as usual, or an individual stress-management intervention in two steps. The first step is a low-intensity stress-management intervention, given to all patients randomized to intervention. Patients who continue to report stress symptoms after the first step will thereafter be given more intensive treatment at the second step of the programme. In the intervention patients will also be motivated to be physically active. Avoidance and intrusion are the primary outcomes. According to the power analyses, 300 patients are planned to be included in the study and will be followed for two years. Other outcomes are physical activity level, sleep duration and quality recorded objectively, and anxiety, depression, quality of life, fatigue, stress in daily living, and patient satisfaction assessed using valid and standardized psychometric tested questionnaires. Utilization of hospital services will be derived from the computerized patient administration systems used by the hospital. The cost-effectiveness of the intervention will be evaluated through a cost-utility analysis. This RCT
Boscarato, Kara; Lee, Stuart; Kroschel, Jon; Hollander, Yitzchak; Brennan, Alice; Warren, Narelle
The manner in which people with mental illness are supported in a crisis is crucial to their recovery. The current study explored mental health consumers' experiences with formal crisis services (i.e. police and crisis assessment and treatment (CAT) teams), preferred crisis supports, and opinions of four collaborative interagency response models. Eleven consumers completed one-on-one, semistructured interviews. The results revealed that the perceived quality of previous formal crisis interventions varied greatly. Most participants preferred family members or friends to intervene. However, where a formal response was required, general practitioners and mental health case managers were preferred; no participant wanted a police response, and only one indicated a preference for CAT team assistance. Most participants welcomed collaborative crisis interventions. Of four collaborative interagency response models currently being trialled internationally, participants most strongly supported the Ride-Along Model, which enables a police officer and a mental health clinician to jointly respond to distressed consumers in the community. The findings highlight the potential for an interagency response model to deliver a crisis response aligned with consumers' preferences. © 2014 Australian College of Mental Health Nurses Inc.
Zand, Debra H.; Pierce, Katherine J.; Bultas, Margaret W.; McMillin, Stephen Edward; Gott, Rolanda Maxim; Wilmott, Jennifer
Parents' involvement in early intervention (EI) services fosters positive developmental trajectories in young children. Although EI research on parenting skills has been abundant, fewer data are available on parents' knowledge of normative child development. Sixty-seven mothers of children participating in a Midwestern city's EI program completed…
Imbody, Bethany; Vandsburger, Etty
With our communities rapidly aging, there is always a clear need for greater knowledge on how to serve elders. Professionals must be able to recognize cases of abuse and neglect and provide appropriate follow up services. Through reviewing recent literature, this paper surveys existing assessment tools and interventions, describes characteristics…
Wagstaff, Amanda E.; Polo, Antonio J.
Depression is more common among adolescents of ethnic minority backgrounds, who also are less likely to receive professional help. This article presents information about prevalence of depression and service use across ethnic groups, and then outlines several promising intervention programs that are designed for adolescents suffering from…
The impact of facility audits, evaluation reports and incentives on motivation and supply management among family planning service providers: an interventional study in two districts in Maputo Province, Mozambique.
Vermandere, Heleen; Galle, Anna; Griffin, Sally; de Melo, Málica; Machaieie, Lino; Van Braeckel, Dirk; Degomme, Olivier
only a monthly audit. During this study, more stock-outs occurred for family planning methods with lower demand, but the number of stock-outs per family planning method in the intervention groups was only significantly lower, compared with the control group, for female condoms. While a rise in motivation was not measurable, stock management was enhanced possibly as a result of the monthly audits. This activity was primarily for data collection, but was described as motivating and supportive, indicating the importance of feedback on health workers' accomplishments. More research is needed to quantify the additional impact of the interventions (distribution of evaluation reports and material incentives) on staff motivation and supply management. Special attention should be paid to supply management of less frequently used contraceptive methods.
This paper aims to examine the impact of service encounter quality on servicevalue evaluation within a higher education context, especially in classlearning process. Service encounter quality was approached with threedimensions, they are : instructor interaction competencies, instructor taskcompetencies and student interaction competencies. Service valueevaluation in this study was called as learning experience value. Somequstionares were distributed to 306 students in some classes. The data ...
Jarden, Mary Ellen; Hovgaard, Doris; Boesen, Ellen
Substantial physical and functional deconditioning and diminished psychological wellbeing are all potential adverse effects of allogeneic stem cell transplantation (allo-HSCT). The aim of this study was to evaluate the feasibility, safety and benefits (physical and functional capacity) of a 4......-6 week supervised and structured mixed-type exercise, progressive relaxation and psychoeducation programme in patients undergoing allo-HSCT. Nineteen patients were randomized to an intervention or a conventional care group (CC) and were tested for physical and functional capacity before admission...... muscle strength, and minimizing loss of physical and functional capacity in patients undergoing allo-HSCT....
Jensen, Ulrich Thy
are based on combinations of survey and administrative data and the dissertation employs a variety of designs such as repeated measures across time and an experiment to advance insights into the effects of organizational leadership and national policies on individuals’ PSM and the behavioral implications......Finding ways to ensure higher public service performance is a key task for scholars and practitioners alike. This dissertation focuses on individuals’ motivation to do good for others and society through public service – public service motivation (PSM). The dissertation examines governance...... interventions as causes of PSM and the implications of PSM for public service behaviors and contributes not only to our understanding of PSM as motivational lever for public service improvements but also offers answers to the question of how PSM is shaped in organizational contexts. The empirical results...
Corley, Nicole A.; Kim, Irang
Objectives: Intervention fidelity is a critical strategy to help advance the usefulness and integrity of social work research. This study assessed the extent to which a selected sample of published social work intervention researchers reported its intervention protocols. Methods: Six core social work journals were reviewed in this analysis. The…
Flaherty-Jones, Graeme M; Carne, Alexandra S; Dexter-Smith, Sarah
This study reports on the evaluation of a group-based intervention for older individuals receiving mental health services. A prospective cohort repeated-measure design was used for 48 participants who accessed secondary care mental health services for older people. Changes on the Recovery Assessment Scale (RAS), the Warwick-Edinburgh Mental Well-Being Scale (WEMWEBS), and a postevaluation questionnaire were analyzed. A paired sample t test examined changes in participant's scores on the WEMWEBS and RAS from baseline to postintervention. Participants qualitatively evaluated the Steps to Recovery group as having a positive effect on their recovery. Following involvement in this group intervention, participants reported improved mental well-being and recovery from mental health difficulty. These results suggest that the program has the potential to provide an accessible framework for developing recovery-orientated approaches in mental health care that can be delivered by care staff at all levels. (c) 2016 APA, all rights reserved).
Jacobs, Bart; Ir, Por; Bigdeli, Maryam; Annear, Peter Leslie; Van Damme, Wim
While World Health Organization member countries embraced the concept of universal coverage as early as 2005, few low-income countries have yet achieved the objective. This is mainly due to numerous barriers that hamper access to needed health services. In this paper we provide an overview of the various dimensions of barriers to access to health care in low-income countries (geographical access, availability, affordability and acceptability) and outline existing interventions designed to overcome these barriers. These barriers and consequent interventions are arranged in an analytical framework, which is then applied to two case studies from Cambodia. The aim is to illustrate the use of the framework in identifying the dimensions of access barriers that have been tackled by the interventions. The findings suggest that a combination of interventions is required to tackle specific access barriers but that their effectiveness can be influenced by contextual factors. It is also necessary to address demand-side and supply-side barriers concurrently. The framework can be used both to identify interventions that effectively address particular access barriers and to analyse why certain interventions fail to tackle specific barriers.
Johnson, Ben; Serban, Nicoleta; Griffin, Paul M; Tomar, Scott L
We evaluated the impact of loan repayment programmes, revising Medicaid fee-for-service rates, and changing dental hygienist supervision requirements on access to preventive dental care for children in Georgia. We estimated cost savings from the three interventions of preventive care for young children after netting out the intervention cost. We used a regression model to evaluate the impact of changing the Medicaid reimbursement rates. The impact of supervision was evaluated by comparing general and direct supervision in school-based dental sealant programmes. Federal loan repayments to dentists and school-based sealant programmes (SBSPs) had lower intervention costs (with higher potential cost savings) than raising the Medicaid reimbursement rate. General supervision had costs 56% lower than direct supervision of dental hygienists for implementing a SBSP. Raising the Medicaid reimbursement rate by 10 percentage points would improve utilization by Loan repayment could serve almost 13 000 children for a cost of $400 000 and a potential cost saving of $176 000. The three interventions all improved met need for preventive dental care. Raising the reimbursement rate alone would marginally affect utilization of Medicaid services but would not substantially increase acceptance of Medicaid by providers. Both loan repayment programmes and amending supervision requirements are potentially cost-saving interventions. Loan repayment programmes provide complete care to targeted areas, while amending supervision requirements of dental hygienists could provide preventive care across the state. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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The Gambia Hepatitis Intervention Study (GHIS is a collaborative undertaking by the International Agency for Research on Cancer, The Government of the Republic of The Gambia and the Medical Research Council of the United Kingdom. This programme was launched in 1986 with the objective of evaluating the efficacy of Hepatitis B (HB vaccination in childhood in the prevention of HB infection, chronic liver disease and primary liver cancer in a population at high risk. The implementation of this trial involves three overlapping phases:
Phase l (1986-1990: V Vaccination accination of appro approximately ximately 60,000 children. HB vaccine, which was approved by the World Health Organisation, was integrated into the Gambian Expanded Programme of Immunisation (EPI in a phased manner over a four-year period from July 1986 to February 1990. During this period, two groups of children were recruited, one comprising about 60,000 children who received all vaccines in the EPI schedule plus the HB vaccine, the other comprising a similar number of children who received all vaccines except HB. Since February 1990, HB vaccination is offered to all newborns as part of the EPI schedule in The Gambia.
Phase ll (1991-1997: Estimate of efficacy of HB vac- vaccine cine against infection and chronic carriage. Longitudinal and cross-sectional surveys were carried out in selected groups of vaccinated (Group 1 and unvaccinated (Group 2. These two subsets have provided evidence of the short-term efficacy of HB vaccine in preventing infection and chronic carriage
Katz, K S; El-Mohandes, P A; Johnson, D M; Jarrett, P M; Rose, A; Cober, M
Women with inadequate prenatal care were recruited to a multi-component parenting intervention study. Because it was anticipated that this high-risk population might present challenges to retention, a variety of strategies were employed to maintain their participation in the study. This report reviews the results of these retention efforts and compares the population that completed the study versus those that terminated prior to study completion. Two hundred and eighty-six women were randomized to an intervention or control group. Careful tracking of the mothers, offering incentives for completing various study activities and providing a culturally competent staff were among the strategies employed to maintain participation. Comparison was made of those mothers terminating before study completion versus those retained, and of those terminating early in the study period versus later. Despite retention efforts, attrition at a level of 41% occurred. A few characteristics of mothers terminating early from the study were significant including older maternal age, a larger number of children, and incidence of no prenatal care. Despite comprehensive tracking procedures, some mothers were lost to follow up after change of residence. Other reasons for attrition included child outplacement and refusal of services or data collection procedures.
Gillis, B; Mobley, C; Stadler, D D; Hartstein, J; Virus, A; Volpe, S L; El ghormli, L; Staten, M A; Bridgman, J; McCormick, S
The HEALTHY study was a randomized, controlled, multicenter and middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Here we describe the design of the HEALTHY nutrition intervention component that was developed to modify the total school food environment, defined to include the following: federal breakfast, lunch, after school snack and supper programs; a la carte venues, including snack bars and school stores; vending machines; fundraisers; and classroom parties and celebrations. Study staff implemented the intervention using core and toolbox strategies to achieve and maintain the following five intervention goals: (1) lower the average fat content of foods, (2) increase the availability and variety of fruits and vegetables, (3) limit the portion sizes and energy content of dessert and snack foods, (4) eliminate whole and 2% milk and all added sugar beverages, with the exception of low fat or nonfat flavored milk, and limit 100% fruit juice to breakfast in small portions and (5) increase the availability of higher fiber grain-based foods and legumes. Other nutrition intervention component elements were taste tests, cafeteria enhancements, cafeteria line messages and other messages about healthy eating, cafeteria learning laboratory (CLL) activities, twice-yearly training of food service staff, weekly meetings with food service managers, incentives for food service departments, and twice yearly local meetings and three national summits with district food service directors. Strengths of the intervention design were the integration of nutrition with the other HEALTHY intervention components (physical education, behavior change and communications), and the collaboration and rapport between the nutrition intervention study staff members and food service personnel at both school
Neikrug, Ariel B; Crawford, Megan R; Ong, Jason C
Patients with hypersomnia disorders (HD) suffer from debilitating symptoms that result in reduced functioning, depression, anxiety, and overall worse quality of life. Little is known about the need and desire of this population to utilize behavioral sleep medicine (BSM) interventions that focus on psychosocial functioning and quality of life, and there have been limited attempts to develop such interventions. The purpose of this survey study was to gather patient-centered data on engagement in pharmacological and nonpharmacological interventions, the psychosocial impact of HD symptoms on quality of life and mental health, and potential interest in BSM services, such as cognitive behavioral therapy, mindfulness or yoga, and support groups. We obtained responses from 371 individuals with HD (65.2% narcolepsy and 34.8% idiopathic hypersomnia) to an Internet-based survey. Overall, HD patients reported engagement in pharmacological and nonpharmacological interventions, with narcolepsy patients reporting more perceived effectiveness than those with idiopathic hypersomnia. In addition, HD patients reported a strong negative impact on psychosocial functioning, with elevations in depression and anxiety symptoms along with significant impact on functioning and quality of life. The majority (71.7-85.5%) voiced at least some interest in BSM services. These data suggest that there is substantial interest and need for BSM services that focus on assessment and treatment of psychosocial functioning related to HD.
Randall, Jason R.; Vokey, Sherri; Loewen, Hal; Martens, Patricia J.; Brownell, Marni; Katz, Alan; Nickel, Nathan C.; Burland, Elaine; Chateau, Dan
Objectives: To review and synthesize the currently available research on whether early intervention for psychosis programs reduce the use of inpatient services. Methods: A systematic review was conducted using keywords searches on PubMed, Embase (Ovid), PsycINFO (ProQuest), Scopus, CINAHL (EBSCO), Social Work Abstracts (EBSCO), Social Science Citations Index (Web of Science), Sociological Abstracts (ProQuest), and Child Development & Adolescent Studies (EBSCO). To be included, studies had to be peer-reviewed publications in English, examining early intervention programs using a variant of assertive community treatment, with a control/comparison group, and reporting inpatient service use outcomes. The primary outcome extracted number hospitalized and total N. Secondary outcome extracted means and standard deviations. Data were pooled using random effects models. Primary outcome was the occurrence of any hospitalization during treatment. A secondary outcome was the average bed-days used during treatment period. Results: Fifteen projects were identified and included in the study. Results of meta-analysis supported the occurrence of a positive effect for intervention for both outcome measures (any hospitalization OR: 0.33; 95% CI 0.18–0.63, bed-days usage SMD: −0.38, 95% CI −0.53 to −0.24). There was significant heterogeneity of effect across the studies. This heterogeneity is due to a handful of studies with unusually positive responses. Conclusion: These results suggest that early intervention programs are superior to standard of care, with respect to reducing inpatient service usage. Wider use of these programs may prevent the occurrence of admission for patients experiencing the onset of psychotic symptoms. PMID:25745034
Randall, Jason R; Vokey, Sherri; Loewen, Hal; Martens, Patricia J; Brownell, Marni; Katz, Alan; Nickel, Nathan C; Burland, Elaine; Chateau, Dan
To review and synthesize the currently available research on whether early intervention for psychosis programs reduce the use of inpatient services. A systematic review was conducted using keywords searches on PubMed, Embase (Ovid), PsycINFO (ProQuest), Scopus, CINAHL (EBSCO), Social Work Abstracts (EBSCO), Social Science Citations Index (Web of Science), Sociological Abstracts (ProQuest), and Child Development & Adolescent Studies (EBSCO). To be included, studies had to be peer-reviewed publications in English, examining early intervention programs using a variant of assertive community treatment, with a control/comparison group, and reporting inpatient service use outcomes. The primary outcome extracted number hospitalized and total N. Secondary outcome extracted means and standard deviations. Data were pooled using random effects models. Primary outcome was the occurrence of any hospitalization during treatment. A secondary outcome was the average bed-days used during treatment period. Fifteen projects were identified and included in the study. Results of meta-analysis supported the occurrence of a positive effect for intervention for both outcome measures (any hospitalization OR: 0.33; 95% CI 0.18-0.63, bed-days usage SMD: -0.38, 95% CI -0.53 to -0.24). There was significant heterogeneity of effect across the studies. This heterogeneity is due to a handful of studies with unusually positive responses. These results suggest that early intervention programs are superior to standard of care, with respect to reducing inpatient service usage. Wider use of these programs may prevent the occurrence of admission for patients experiencing the onset of psychotic symptoms. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.
Jones, Jannah; Wolfenden, Luke; Wyse, Rebecca; Finch, Meghan; Yoong, Sze Lin; Dodds, Pennie; Pond, Nicole; Gillham, Karen; Freund, Megan; McElduff, Patrick; Wye, Paula; Wiggers, John
Childhood overweight and obesity tracks into adulthood, increasing the risk of developing future chronic disease. Implementing initiatives promoting healthy eating and physical activity in childcare settings has been identified as a priority to prevent excessive child weight gain. Despite this, few trials have been conducted to assess the effectiveness of interventions to support population-wide implementation of such initiatives. The aim of this study is to assess the effectiveness of a multicomponent intervention in increasing the implementation of healthy eating and physical activity policies and practices by centre-based childcare services. The study will employ a parallel group randomised controlled trial design. A sample of 128 childcare services in the Hunter region of New South Wales, Australia, will be recruited to participate in the trial. 64 services will be randomly allocated to a 12-month implementation intervention. The remaining 64 services will be allocated to a usual care control group. The intervention will consist of a number of strategies to facilitate childcare service implementation of healthy eating and physical activity policies and practices. Intervention strategies will include implementation support staff, securing executive support, consensus processes, staff training, academic detailing visits, performance monitoring and feedback, tools and resources, and a communications strategy. The primary outcome of the trial will be the prevalence of services implementing all healthy eating and physical activity policies and practices targeted by the intervention. To assess the effectiveness of the intervention, telephone surveys with nominated supervisors and room leaders of childcare services will be conducted at baseline and immediately postintervention. The study was approved by the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee. Study findings will be disseminated widely
Abbott, Yuko; Shah, Nina R.; Ward, Kristy K.; McHale, Michael T.; Alvarez, Edwin A.; Saenz, Cheryl C.; Plaxe, Steven C.
The purpose of this study was to determine whether the introduction of psychosocial services to gynecologic oncology outpatients by a social worker increases service use. During the initial six weeks (phase I), patients were referred for psychosocial services by clinic staff. During the second six weeks (phase II), a nurse introduced available…
Fagan, Johan J; Jacobs, Marian
Burden of disease (BOD) is greatest in resource-starved regions such as Africa. Even though hearing disability ranks third on the list of non-fatal disabling conditions in low- and middle-income countries, ear, nose, and throat (ENT) disorders are not specifically coded for within the framework governing global BOD estimates, and in discussions about health challenges, non-communicable diseases receive scant attention. Implementing cost-effective interventions to address conditions largely neglected by global estimates of BOD such as hearing loss are important contributors to health and economic development. Establish a database of ENT, audiology, and speech therapy services in Sub-Saharan Africa; create awareness about the status of these services; propose effective intervention; gather data to lobby African governments, donor countries, and aid organizations; determine need for Developing World Forum for ENT, Audiology, and Speech Therapy services. Survey of ENT, audiology, and speech therapy services and training in 18 Sub-Saharan Africa countries. There is an alarming paucity of services and training opportunities, and there is a large gap between higher technology, expensive health care in high-income countries and lower technology, low-cost practice in low-income countries. Lower technology and lower cost Developing World medical practice should be recognized and fostered as a field of medical practice, teaching, and research. Developing World centers of excellence must be fostered to take a lead in teaching, training, and research. A Developing World Forum for ENT Surgery, Audiology, and Speech Therapy, directed and driven by Africa and the Developing World, supported by the First World, should be established, to develop a comprehensive intervention to turn around the severe shortage of services and expertise in the Developing World. Global health policies and practices should include new norms and standards which serve the interests of the global community
Objective: To review the findings of safe motherhood intervention studies conducted in African settings. Data sources: Published literature regarding interventions designed to reduce maternal mortality in African settings. Study selection: Studies conducted in sub-Saharan Africa to assess the effects of interventions designed ...
Jones, Rowena; Banbury, Luke
There is a growing body of research looking into the high rates of victimization amongst people with severe mental illness. Studies to date have tended to look at victimization rates in people with chronic mental illness over a wide age range. However, national crime surveys indicate that younger people are more likely to be the victim of crime than older people. There is also evidence that people from ethnic minorities are more likely to experience and less likely to report criminal victimization. This study therefore aimed to look at victimization rates specifically in young people with first episode psychosis (FEP) in Birmingham, one of the most youthful and ethnically diverse cities in the UK. Patients with FEP under the South Birmingham Early Intervention Service were asked to complete a modified version of the Crime Survey for England and Wales (CSEW). Data was compared to control-group data from the CSEW 2014. Patients with FEP were significantly more likely to be victims of crime, in particular violent crime, than their age-matched counterparts. The overall victimization rate was 39%. Black and Minority Ethnic (BME) groups were more likely to be victims of personal and violent crime than the white FEP population. Victimization rates were broadly in keeping with other UK and international studies. Young people with FEP, particularly those from BME backgrounds, are at significantly greater risk of victimhood than the general population of the West Midlands. © 2017 John Wiley & Sons Australia, Ltd.
This rule reissues the current regulations and: Establishes policy, assigns responsibilities, and implements the non-funding and non-reporting provisions in DoD for: Provision of early intervention services (EIS) to infants and toddlers with disabilities and their families, as well as special education and related services to children with disabilities entitled under this part to receive education services from the DoD; implementation of a comprehensive, multidisciplinary program of EIS for infants and toddlers with disabilities and their families who, but for age, are eligible to be enrolled in DoD schools; provision of a free appropriate public education (FAPE), including special education and related services, for children with disabilities, as specified in their individualized education programs (IEP), who are eligible to enroll in DoD schools; and monitoring of DoD programs providing EIS, and special education and related services for compliance with this part. This rule also establishes a DoD Coordinating Committee to recommend policies and provide compliance oversight for early intervention and special education.
Mhimbira, Francis A; Cuevas, Luis E.; Dacombe, Russell; Mkopi, Abdallah; Sinclair, David
Background Pulmonary tuberculosis is usually diagnosed when symptomatic individuals seek care at healthcare facilities, and healthcare workers have a minimal role in promoting the health-seeking behaviour. However, some policy specialists believe the healthcare system could be more active in tuberculosis diagnosis to increase tuberculosis case detection. Objectives To evaluate the effectiveness of different strategies to increase tuberculosis case detection through improving access (geographical, financial, educational) to tuberculosis diagnosis at primary healthcare or community-level services. Search methods We searched the following databases for relevant studies up to 19 December 2016: the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library, Issue 12, 2016; MEDLINE; Embase; Science Citation Index Expanded, Social Sciences Citation Index; BIOSIS Previews; and Scopus. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, and the metaRegister of Controlled Trials (mRCT) for ongoing trials. Selection criteria Randomized and non-randomized controlled studies comparing any intervention that aims to improve access to a tuberculosis diagnosis, with no intervention or an alternative intervention. Data collection and analysis Two review authors independently assessed trials for eligibility and risk of bias, and extracted data. We compared interventions using risk ratios (RR) and 95% confidence intervals (CI). We assessed the certainty of the evidence using the GRADE approach. Main results We included nine cluster-randomized trials, one individual randomized trial, and seven non-randomized controlled studies. Nine studies were conducted in sub-Saharan Africa (Ethiopia, Nigeria, South Africa, Zambia, and Zimbabwe), six in Asia (Bangladesh, Cambodia, India, Nepal, and Pakistan), and two in South America
van Wyk, Sierra; Schweitzer, Robert; Brough, Mark; Vromans, Lyn; Murray, Kate
Objective The present study seeks to examine the impact of therapeutic interventions for refugees within a naturalistic setting. Method Sixty-two refugees from Burma were assessed soon after arriving in Australia. All participants received standard interventions provided by a resettlement organisation which included therapeutic interventions, assessment, social assistance, and referrals where appropriate. At the completion of service provision a follow-up assessment was conducted. Results Over the course of the intervention, participants experienced a significant decrease in symptoms of post-traumatic stress disorder, anxiety, depression and somatisation. Pre-intervention symptoms predicted symptoms post-intervention for post-traumatic stress, anxiety, and somatisation. Post-migration living difficulties, the number of traumas experienced, and the number of contacts with the service agency were unrelated to all mental health outcomes. Conclusions In the first Australian study of its kind, reductions in mental health symptoms post-intervention were significantly linked to pre-intervention symptomatology and the number of therapy sessions predicted post-intervention symptoms of post-traumatic stress. Future studies need to include larger samples and control groups to verify findings. PMID:22431841
Pfefferbaum, Betty; North, Carol S
Several decades of research have informed our knowledge of children's reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.
Swan, Holly; Hiller, Matthew L; Albizu-García, Carmen E; Pich, Michele; Patterson, Yvonne; O'Connell, Daniel J
The prevalence of HIV among U.S. inmates is much greater than in the general population, creating public health concerns and cost issues for the criminal justice system. The HIV Services and Treatment Implementation in Corrections protocol of the NIDA funded Criminal Justice Drug Abuse Treatment Studies cooperative tested the efficacy of an organizational process improvement strategy on improving HIV services in correctional facilities. For this paper, we analyzed efficacy of this strategy on improving inmate awareness and perceptions of HIV services. The study used a multi-site (n=28) clustered randomized trial approach. Facilities randomized to the experimental condition used a coach-driven local change team approach to improve HIV services at their facility. Facilities in the control condition were given a directive to improve HIV services on their own. Surveys about awareness and perceptions of HIV services were administered anonymously to inmates who were incarcerated in study facilities at baseline (n=1253) and follow-up (n=1048). A series of one-way ANOVAs were run to test whether there were differences between inmates in the experimental and control facilities at baseline and follow-up. Differences were observed at baseline, with the experimental group having significantly lower scores than the control group on key variables. But, at post-test, following the intervention, these differences were no longer significant. Taken in context of the findings from the main study, these results suggest that the change team approach to improving HIV services in correctional facilities is efficacious for improving inmates' awareness and perceptions of HIV services.
Ambia, Julie; Mandala, Justin
The success of prevention of mother-to-child transmission of HIV (PMTCT) is dependent upon high retention of mother-infant pairs within these programmes. This is a systematic review to evaluate the effectiveness of interventions that aim to improve PMTCT service delivery and promote retention throughout the PMTCT steps. Selected databases were searched for studies published in English (up to September 2015). Outcomes of interest included antiretroviral (ARV) drugs or antiretroviral therapy (ART) initiation among HIV-positive pregnant and/or breastfeeding women and their infants, retention into PMTCT programs, the uptake of early infant diagnosis (EID) of HIV and infant HIV status. Risk ratios and random-effect meta-analysis were used in the analysis. Interventions assessed in the 34 identified studies included male partner involvement in PMTCT, peer mentoring, the use of community health workers (CHWs), mobile phone-based reminders, conditional cash transfer, training of midwives, integration of PMTCT services and enhanced referral. Five studies (two randomized) that evaluated mobile phone-based interventions showed a statistically significant increase (pooled RR 1.18; 95% CI 1.05 to 1.32, I(2)=83%) in uptake of EID of HIV at around six weeks postpartum. Male partner involvement in PMTCT was associated with reductions in infant HIV transmission (pooled RR 0.61; 95% CI 0.39 to 0.94, I(2)=0%) in four studies (one randomized). Four studies (three randomized) that were grounded on psychological interventions reported non-significant results (pooled RR 1.01; 95% CI 0.93 to 1.09, I(2)=69%) in increasing ARV/ART uptake among HIV-positive pregnant and/or breastfeeding women and infant HIV testing (pooled RR 1.00; 95% CI 0.94 to 1.07, I(2)=45%). The effect of the other interventions on the effectiveness of improving PMTCT uptake was unclear. Heterogeneity of interventions limits these findings. Our findings indicate that mobile phone-based reminders may increase the uptake
Suravi Patra; Priti Arun; Bir Singh Chavan
Context: Parents of children with autism spectrum disorders (ASD) in India face a host of challenges, while seeking care which ranges from unavailability of information to difficulty in availing services. Aims: To develop a psycho-education intervention module for parents of children with ASD and to study its impact on parent stress and knowledge. Settings and Design: Child Guidance Clinic Department of Psychiatry, Government Medical College and Hospital, Chandigarh. Interventional study. Met...
Agnes Y. Lai
Full Text Available IntroductionEvaluation studies on train-the-trainer workshops (TTTs to develop family well-being interventions are limited in the literature. The Logic Model offers a framework to place some important concepts and tools of intervention science in the hands of frontline service providers. This paper reports on the evaluation of a TTT for a large community-based program to enhance family well-being in Hong Kong.MethodsThe 2-day TTT introduced positive psychology themes (relevant to the programs that the trainees would deliver and the Logic Model (which provides a framework to guide intervention development and evaluation for social service workers to guide their community-based family interventions. The effectiveness of the TTT was examined by self-administered questionnaires that assessed trainees’ changes in learning (perceived knowledge, self-efficacy, attitude, and intention, trainees’ reactions to training content, knowledge sharing, and benefits to their service organizations before and after the training and then 6 months and 1 year later. Missing data were replaced by baseline values in an intention-to-treat analysis. Focus group interviews were conducted approximately 6 months after training.ResultsFifty-six trainees (79% women joined the TTT. Forty-four and 31 trainees completed the 6-month and 1-year questionnaires, respectively. The trainees indicated that the workshop was informative and well organized. The TTT-enhanced trainees’ perceived knowledge, self-efficacy, and attitudes toward the application of the Logic Model and positive psychology constructs in program design. These changes were present with small to large effect size that persisted to the 1 year follow-up. The skills learned were used to develop 31 family interventions that were delivered to about 1,000 families. Qualitative feedback supported the quantitative results.ConclusionThis TTT offers a practical example of academic-community partnerships that
Lai, Agnes Y; Stewart, Sunita M; Mui, Moses W; Wan, Alice; Yew, Carol; Lam, Tai Hing; Chan, Sophia S
Evaluation studies on train-the-trainer workshops (TTTs) to develop family well-being interventions are limited in the literature. The Logic Model offers a framework to place some important concepts and tools of intervention science in the hands of frontline service providers. This paper reports on the evaluation of a TTT for a large community-based program to enhance family well-being in Hong Kong. The 2-day TTT introduced positive psychology themes (relevant to the programs that the trainees would deliver) and the Logic Model (which provides a framework to guide intervention development and evaluation) for social service workers to guide their community-based family interventions. The effectiveness of the TTT was examined by self-administered questionnaires that assessed trainees' changes in learning (perceived knowledge, self-efficacy, attitude, and intention), trainees' reactions to training content, knowledge sharing, and benefits to their service organizations before and after the training and then 6 months and 1 year later. Missing data were replaced by baseline values in an intention-to-treat analysis. Focus group interviews were conducted approximately 6 months after training. Fifty-six trainees (79% women) joined the TTT. Forty-four and 31 trainees completed the 6-month and 1-year questionnaires, respectively. The trainees indicated that the workshop was informative and well organized. The TTT-enhanced trainees' perceived knowledge, self-efficacy, and attitudes toward the application of the Logic Model and positive psychology constructs in program design. These changes were present with small to large effect size that persisted to the 1 year follow-up. The skills learned were used to develop 31 family interventions that were delivered to about 1,000 families. Qualitative feedback supported the quantitative results. This TTT offers a practical example of academic-community partnerships that promote capacity among community social service workers
Cason, Jana; Behl, Diane; Ringwalt, Sharon
Early intervention (EI) services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC, 2011). EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community. A survey sent by the National Early Childhood Technical Assistance Center (NECTAC) to IDEA Part C coordinators assessed their utilization of telehealth within states' IDEA Part C programs. Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified. Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey. Of these, 30% (n=9) indicated that they are either currently using telehealth as an adjunct service delivery model (n=6) or plan to incorporate telehealth within the next 1-2 years (n=3). Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH), speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters. Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance. Expressed barriers and concerns for the implementation of telehealth as a delivery model within Part
Müssener, Ulrika; Bendtsen, Marcus; Karlsson, Nadine; White, Ian R; McCambridge, Jim; Bendtsen, Preben
Smoking is globally the most important preventable cause of ill health and death. Mobile telephone interventions and, in particular, short message service (SMS) text messaging, have the potential to overcome access barriers to traditional health services, not least among young people. To determine the effectiveness of a text-based smoking cessation intervention among young people. A single-blind, 2-arm, randomized clinical trial (Nicotine Exit [NEXit]) was conducted from October 23, 2014, to April 17, 2015; data analysis was performed from April 23, 2014, to May 22, 2015. Participants included daily or weekly smokers willing to set a quit date within 1 month of enrollment. The study used email to invite all college and university students throughout Sweden to participate. The NEXit core program is initiated with a 1- to 4-week motivational phase during which participants can choose to set a stop date. The intervention group then received 157 text messages based on components of effective smoking cessation interventions for 12 weeks. The control group received 1 text every 2 weeks thanking them for participating in the study, with delayed access to the intervention. The primary outcomes were self-reported prolonged abstinence (not having smoked >5 cigarettes over the past 8 weeks) and 4-week point prevalence of complete smoking cessation shortly after the completion of the intervention (approximately 4 months after the quit date). A total of 1590 participants, mainly between 21 and 30 years of age, were randomized into the study; 827 (573 [69.3%] women) were allocated to the intervention group and 763 (522 [68.4%] women) were included in the control group. Primary outcome data were available for 783 (94.7%) of the intervention group and 719 (94.2%) of the control group. At baseline, participants were smoking a median (range) of 63 (1-238) and 70 (2-280) cigarettes per week, respectively. Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the
Downing, J; Gleeson, H; Clayton, P E; Davis, J R E; Dimitri, P; Wales, J; Young, B; Callery, P
Communication is complex in endocrine care, particularly during transition from paediatric to adult services. The aims of this study were to examine the feasibility of interventions to support young people to interact with clinicians. Development and evaluation of a complex intervention in 2 phases: Pre-intervention observational study; Intervention feasibility study. Purposive sample of recordings of 62 consultations with 58 young people aged 11-25 years with long-term endocrine conditions in two paediatric and two adult endocrine clinics. Proportion of time talked during consultations, number and direction of questions asked; Paediatric Consultation Assessment Tool (PCAT); OPTION shared decision making tool; Medical Information Satisfaction Scale (MISS- 21). Young people were invited to use one or more of: a prompt sheet to help them influence consultation agendas and raise questions; a summary sheet to record key information; and the www.explain.me.uk website. Nearly two thirds of young people (63%) chose to use at least one communication intervention. Higher ratings for two PCAT items (95% CI 0.0 to 1.1 and 0.1 to 1.7) suggest interventions can support consultation skills. A higher proportion of accompanying persons (83%) than young people (64%) directed questions to clinicians. The proportion of young people asking questions was higher (84%) in the intervention phase than in the observation phase (71%). Interventions were acceptable and feasible. The Intervention phase was associated with YP asking more questions, which implies that the availability of interventions could promote interactivity.
Leung, Man Huen Jenny
Studies on service quality are popular but specifically on service quality of mobile network services industry in Hong Kong are scarce. This paper aims at developing a service quality dimension for the mobile network services industry in Hong Kong. The study investigates the service quality of the six network operators in Hong Kong and explores the determinants of service quality in the industry. It studies the impact of service quality on both customer satisfaction and behavioral intentions....
Gu, Moli; Ma, Yanlan; Zhou, Ti; Xia, Yunfeng
Although the role of primary care for the management of patients with chronic heart failure (CHF) has been highly recommended, structural involvement of primary care in heart failure (HF) management programs is extremely limited. To examine the feasibility and applicability of two most recommended forms of care delivery mode, home visit and telephone support, for CHF management in the setting of community health service center (CHSC). Prospective study. This study was conducted in two CHSCs in Beijing, China. Care delivery was led by trained general practitioners or community nurses via home visits in one CHSC and telephone support in the other. Data regarding the change in mortality and hospitalization rate during 12 months and self-care level at 6 months were prospectively collected and compared across the intervention groups. A total of 329 patients were included, with 142 in the home visit group and 187 in the telephone support group. Patients in both groups had frequent visits to CHSC (8.1±5.9 in the home visit and 7.7±4.1 in the telephone support group, p=0.45) during the follow-up period. Compared to the telephone support group, patients in the home visit group showed a reduction in all-cause mortality (14.1% versus 20.3%, p=0.14), one or more hospitalizations due to any cause (33.8% versus 44.2%, p=0.12) and one or more hospitalizations due to cardiac cause (17.6% versus 24.6%, p=0.13) in the home visit group. The absolute differences were 6.2% (95% CI: 1.9%, 14.3%), 8.4% (95% CI: 2.1%, 18.9%) and 7.3% (95% CI: 1.5%, 16.1%), respectively, although the results were not statistically significant. After 6 months of intervention, patients in both groups achieved marked improvement in self-care with reference to their own baseline values. Although no statistical difference was observed between the two care delivery approaches regarding the clinical outcomes of interest, given the high participation rates, the acceptable rate of adverse events, frequent CHSC
Suzuki, Rie; Peterson, Jana J; Weatherby, Amanda V; Buckley, David I; Walsh, Emily S; Kailes, June Isaacson; Krahn, Gloria L
This article describes the development of Promoting Access to Health Services (PATHS), an intervention to promote regular use of clinical preventive services by women with physical disabilities. The intervention was developed using intervention mapping (IM), a theory-based logical process that incorporates the six steps of assessment of need, preparation of matrices, selection of theoretical methods and strategies, program design, program implementation, and evaluation. The development process used methods and strategies aligned with the social cognitive theory and the health belief model. PATHS was adapted from the workbook Making Preventive Health Care Work for You, developed by a disability advocate, and was informed by participant input at five points: at inception through consultation by the workbook author, in conceptualization through a town hall meeting, in pilot testing with feedback, in revision of the curriculum through an advisory group, and in implementation by trainers with disabilities. The resulting PATHS program is a 90-min participatory small-group workshop, followed by structured telephone support for 6 months.
Wandin, Helena; Lindberg, Per; Sonnander, Karin
To investigate communication intervention that speech language pathologists (SLPs) provide to people with Rett syndrome. A web-based survey targeting all Swedish SLPs working with people currently receiving support from habilitation services. The SLPs reportedly followed recommended practice in the following aspects: (1) Information on communicative function was collected from several sources, including observation in well-known settings and reports from the client s social network, (2) Multimodal communication was promoted and, (3) Responsive partner strategies were largely targeted in the intervention. However, few instruments or standard procedures were used and partner instruction was given informally. Most SLPs used communication aids in the intervention and their general impression of using communication aids was positive. Further, augmentative and alternative communication (AAC) was estimated to increase and clarify communicative contributions from the person. Communication aids were reported to have a positive influence on communicative functions. Swedish SLP services followed best practice in several aspects, but there are areas with potential for development. Tools and best practice guidelines are needed to support SLPs in the AAC process for clients with Rett syndrome. [Box: see text].
Hackstadt, Amber J; Matsui, Elizabeth C; Williams, D'Ann L; Diette, Gregory B; Breysse, Patrick N; Butz, Arlene M; Peng, Roger D
Previous research has found evidence of an association between indoor air pollution and asthma morbidity in children. Environmental intervention studies have been performed to examine the role of household environmental interventions in altering indoor air pollution concentrations and improving health. Previous environmental intervention studies have found only modest effects on health outcomes and it is unclear if the health benefits provided by environmental modification are comparable with those provided by medication. Traditionally, the statistical analysis of environmental intervention studies has involved performing two intention-to-treat analyses that separately estimate the effect of the environmental intervention on health and the effect of the environmental intervention on indoor air pollution concentrations. We propose a principal stratification approach to examine the extent to which an environmental intervention's effect on health outcomes coincides with its effect on indoor air pollution. We apply this approach to data from a randomized air cleaner intervention trial conducted in a population of asthmatic children living in Baltimore, Maryland, USA. We find that among children for whom the air cleaner reduced indoor particulate matter concentrations, the intervention resulted in a meaningful improvement of asthma symptoms with an effect generally larger than previous studies have shown. A key benefit of using principal stratification in environmental intervention studies is that it allows investigators to estimate causal effects of the intervention for sub-groups defined by changes in the indoor air pollution concentration. Copyright © 2014 John Wiley & Sons, Ltd.
Salmani, Zahra; Zargham-Boroujeni, Ali; Salehi, Mehrdad; K Killeen, Therese; Merghati-Khoei, Effat
In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, "pearl-growing" techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, "orgasm AND intervention". Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols to screen, assessment and management of women' sexual problems such as FOD
Masood, Junaid; Ismail, Mohamed; El-Husseiny, Tamer; Moraitis, Konstantinos; Albanis, Stephanos; Papatsoris, Athanasios; Buchholz, Noor
INTRODUCTION Almost all patients in the UK with obstructed and/or infected kidneys are referred to interventional radiology for percutaneous nephrostomy and/or placement of an anterograde JJ stent. Although this ‘tradition’ is going strong in the UK, urologists throughout the world have evolved their practice to encompass such interventional procedures in their remit. We have set up a local anaesthetic list ‘interventional urology list’ in our ESWL suite. We present our 4-year experience and discuss the benefits that this interventional list brings to our patients, our trainees, our interventional radiology colleagues and to the hospital trust. PATIENTS AND METHODS From May 2005 to May 2009, we have been running this list, twice-weekly, performing procedures such as nephrostomies, anterograde stents, nephrostograms and stent exchanges all under local anaesthetic. RESULTS A total of 580 procedures have been carried out on this list over this period. Our success rate for nephrostomy insertion is 96% with three failures, as a result of patient discomfort. No major complications and three minor complications were reported. We had four failed anterograde stenting procedures (out of 80). All other procedures including nephrostograms, stent exchanges/removals/insertions, as well as renal cyst aspiration and sclerotisation were successfully carried out. CONCLUSIONS Our results of percutaneous nephrostomy and antegrade stenting are favourable when compared with published data on nephrostomies. This novel set up has resulted in several improvements to the service we offer patients and also provided significant improvement in training for our residents. We encourage other departments to try and develop this type of ‘interventional urology list’. PMID:20977835
Melau, Marianne; Albert, Nikolai; Nordentoft, Merete
BACKGROUND: The efficacy of the Specialized Early Intervention (SEI) treatment in Denmark, the OPUS treatment, has in a randomized clinical trial proved to be very effective compared to treatment as usual, and the dissemination of SEI services is increasing in Denmark. A prerequisite for upholdin......). The maximum score was a total of 18 points with 5 of the components being mandatory. CONCLUSION: The development of the fidelity scale is an important tool for securing the quality of SEI treatment in Denmark.......BACKGROUND: The efficacy of the Specialized Early Intervention (SEI) treatment in Denmark, the OPUS treatment, has in a randomized clinical trial proved to be very effective compared to treatment as usual, and the dissemination of SEI services is increasing in Denmark. A prerequisite for upholding...... positive effects along with creating new teams and preserving critical components is to ensure fidelity to the model. Currently there is no Danish fidelity scale for SEI services. AIM: To establish a fidelity scale for SEI teams, in a brief and easily manageable form, for the use of evaluating...
Brittni N. Howard
Full Text Available Abstract Background Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women’s Health CoOp (WHC in clinics and substance abuse rehab settings in Cape Town, South Africa. Methods We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs. Results All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities. Conclusions In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women’s risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to
Sultana, Sarmin; Rana, Shohel
The customer‘s standard of living and consciousness is demanding the importance of service quality. Service quality is mandatory to provide added value to the customers, retain and make loyal customers. This paper focuses on the customer expectation, customer perception and the gap between customer expectation and perception to measure the service quality. We have analyzed the service quality which has a great impact on customer satisfaction.
Intervention and management of developmental coordination disorder: Are we providing evidence-based services?: Intervention et traitement d'un trouble du développement de la coordination : Les ergothérapeutes fournissent-ils des services fondés sur les faits scientifiques?
Withers, Renée; Tsang, Yoyo; Zwicker, Jill G
Occupational therapists are well positioned to provide intervention to improve outcomes for children with developmental coordination disorder. However, little is known about what occupational therapy services are provided for these children. As part of a larger study exploring service provision for children with developmental coordination disorder, the purpose of this study was to examine intervention and referral practices of occupational therapists in British Columbia, Canada. An online survey was e-mailed to a convenience and snowball sample of paediatric occupational therapists, with 165 therapists responding. Descriptive statistics were used for the data analysis. Results show that the type and duration of intervention varied greatly throughout the province, as well as within health regions. Although 70% (87/124) of therapists reported being at least moderately familiar with current evidence, only 47% to 59% selected task-based methods as their primary intervention approach. Findings provide a baseline for current intervention and an opportunity for targeted knowledge translation initiatives.
Marlowe, Douglas B; Festinger, David S; Arabia, Patricia L; Dugosh, Karen L; Benasutti, Kathleen M; Croft, Jason R
Adaptive interventions apply a priori decision rules for adjusting treatment services in response to participants' clinical presentation or performance in treatment. This pilot study (n = 30) experimentally examined an adaptive intervention in a misdemeanor drug court. The participants were primarily charged with possession of marijuana (73%) or possession of drug paraphernalia (23%). Results revealed that participants in the adaptive condition had higher graduation rates and required significantly less time to graduate from the program and achieve a final resolution of the case. It took an average of nearly 4 fewer months for participants in the adaptive intervention to resolve their cases compared with those participating in drug court as usual. Participants in the adaptive condition also reported equivalent satisfaction with the program and therapeutic alliances with their counselors. These data suggest that adaptive interventions may enhance the efficiency and effectiveness of drug courts and justify examining adaptive interventions in large-scale drug court studies.
Full Text Available Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. Materials and Methods: For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. Results: The majority of interventions (90% related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Conclusion: Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well
Salmani, Zahra; Zargham-Boroujeni, Ali; Salehi, Mehrdad; K.Killeen, Therese; Merghati-Khoei, Effat
Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. Materials and Methods: For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. Results: The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Conclusion: Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols
Ziviani, Jenny; Feeney, Rachel B.; Khan, Asad
Family-centered early childhood services for children with physical disability and their families can afford developmental advantage for children and avert unnecessary stress for families. This study aimed to determine how characteristics of children and families and perceptions of family-centered practice (FCP) relate to satisfaction with early…
Meadan, Hedda; Daczewitz, Marcus E.
Efficient early intervention (EI) services are required to serve the needs of young children with disabilities and the needs of their families. Effective EI includes family-centred practices, evidence-based interventions, parent involvement/training, and delivery in children's natural environments. Due to the challenges of providing…
... 32 National Defense 1 2010-07-01 2010-07-01 false DoD-CC on Early Intervention, Special Education... SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN PROVISION OF EARLY INTERVENTION AND SPECIAL EDUCATION..., Special Education, and Related Services A. Committee Membership The DoD-CC shall meet at least yearly to...
Full Text Available This paper investigates a support service supply chain for coordinating with a local third-party logistics provider by arms offset program’s intervention and develops a performance-based contracting framework for the coordinating problem, which remains scarce in the literatures. The performance-based contracting framework evaluates payments and profits for the support service by a game-theoretical approach with principal-agent model. We prove that the proposed framework is an effective tool in acquiring the balance between maximum profit and minimum payment for both parties in the coordinating problem without moral hazard issue. A numerical study consolidates the formulated schemes as contracting preference for both parties’ decision with a higher profit margin at a lower customer’s payment.
Kairaluoma, Leila; Ahonen, Timo; Aro, Mikko; Holopainen, Leena
This study is an intervention case study of fluency in Finnish-speaking children with dyslexia. Two 7-year-old children, a girl and a boy, were selected from the Jyvaskyla Longitudinal Study of Dyslexia. The intervention emphasised syllables as reading units, and proceeded from reading syllables to reading words and text. Letter knowledge, reading…
Verbeek, J.; Salmi, J.; Pasternack, I.; Jauhiainen, M.; Laamanen, I.; Schaafsma, F.; Hulshof, C.; van Dijk, F.
As a result of low numbers and diversity in study type, occupational health intervention studies are not easy to locate in electronic literature databases. To develop a search strategy that facilitates finding occupational health intervention studies in Medline, both for researchers and
Hackstadt, A. J.; Butz, Arlene M.; Williams, D’Ann L.; Diette, Gregory B.; Breysse, Patrick N.; Matsui, Elizabeth C.; Peng, Roger D.
Previous research has found evidence of an association between indoor air pollution and asthma morbidity in children. Environmental intervention studies have been performed to examine the role of household environmental interventions in altering indoor air pollution concentrations and improving health. Previous environmental intervention studies have found only modest effects on health outcomes and it is unclear if the health benefits provided by environmental modification are comparable to t...
Shaw, Jerome M.; Lyon, Edward G.; Stoddart, Trish; Mosqueda, Eduardo; Menon, Preetha
This paper present findings from a pre-service teacher development project that prepared novice teachers to promote English language and literacy development with inquiry-based science through a modified elementary science methods course and professional development for cooperating teachers. To study the project's impact on student learning, we administered a pre and post assessment to students (N = 191) of nine first year elementary teachers (grades 3 through 6) who experienced the intervention and who taught a common science unit. Preliminary results indicate that (1) student learning improved across all categories (science concepts, writing, and vocabulary)—although the effect varied by category, and (2) English Language Learner (ELL) learning gains were on par with non-ELLs, with differences across proficiency levels for vocabulary gain scores. These results warrant further analyses to understand the extent to which the intervention improved teacher practice and student learning. This study confirms the findings of previous research that the integration of science language and literacy practices can improve ELL achievement in science concepts, writing and vocabulary. In addition, the study indicates that it is possible to begin to link the practices taught in pre-service teacher preparation to novice teacher practice and student learning outcomes.
Whitehead, Phillip J; Worthington, Esme J; Parry, Ruth H; Walker, Marion F; Drummond, Avril E R
To identify interventions that aim to reduce dependency in activities of daily living (ADL) in homecare service users. To determine: content; effectiveness in improving ability to perform ADL; and whether delivery by qualified occupational therapists influences effectiveness. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, OTseeker, PEDro, Web of Science, CIRRIE, and ASSIA. We included: randomised controlled trials, non-randomised controlled trials and controlled before and after studies. Two reviewers independently screened studies for inclusion, assessed risk of bias and extracted data. A narrative synthesis of the findings was conducted. Thirteen studies were included, totalling 4975 participants. Ten (77%) were judged to have risk of bias. Interventions were categorised as those termed 're-ablement' or 'restorative homecare' (n=5/13); and those involving separate components which were not described using this terminology (n=8/13). Content of the intervention and level of health professional input varied within and between studies. Effectiveness on ADL: eight studies included an ADL outcome, five favoured the intervention group, only two with statistical significance, both these were controlled before and after studies judged at high risk of bias. ADL outcome was reported using seven different measures. Occupational therapy: there was insufficient evidence to determine whether involvement of qualified occupational therapists influenced effectiveness. There is limited evidence that interventions targeted at personal ADL can reduce homecare service users' dependency with activities, the content of evaluated interventions varies greatly. © The Author(s) 2015.
George, Asha S; Branchini, Casey; Portela, Anayda
... to increase use of maternity care services. Using inclusion and exclusion criteria defined in a peer-reviewed protocol, we searched published and grey literature from one database of studies on maternal health, two search engines, an internet...
Ramke, Jacqueline; Petkovic, Jennifer; Welch, Vivian; Blignault, Ilse; Gilbert, Clare; Blanchet, Karl; Christensen, Robin; Zwi, Anthony B; Tugwell, Peter
Cataract is the leading cause of blindness in low- and middle-income countries (LMICs), and the prevalence is inequitably distributed between and within countries. Interventions have been undertaken to improve cataract surgical services, however, the effectiveness of these interventions on promoting equity is not known. To assess the effects on equity of interventions to improve access to cataract services for populations with cataract blindness (and visual impairment) in LMICs. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 3), MEDLINE Ovid (1946 to 12 April 2017), Embase Ovid (1980 to 12 April 2017), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 12 April 2017), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 12 April 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 12 April 2017 and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 12 April 2017. We did not use any date or language restrictions in the electronic searches for trials. We included studies that reported on strategies to improve access to cataract services in LMICs using the following study designs: randomised and quasi-randomised controlled trials (RCTs), controlled before-and-after studies, and interrupted time series studies. Included studies were conducted in LMICs, and were targeted at disadvantaged populations, or disaggregated outcome data by 'PROGRESS-Plus' factors (Place of residence; Race/ethnicity/ culture/ language; Occupation; Gender/sex; Religion; Education; Socio-economic status; Social capital/networks. The 'Plus' component includes disability, sexual orientation and age). Two authors (JR and JP) independently selected studies, extracted data and assessed them for risk of bias. Meta-analysis was not possible, so included studies were
Chappuy, M; Garcia, S; Uhres, A-C; Janoly-Dumenil, A; Dessault, J; Chamouard, V; Bréant, V; Leboucher, G; Pivot, C; Carpentier, I
For public health reasons, some drugs are only available in hospital drugs sales service. This activity takes place in a specific risk context of organization, patients and/or drugs. A systematic prescription analysis by pharmacist contributes to securise treatment dispensed. The aim of this paper is to present the main drugs problems in the analysis of outpatient prescriptions and pharmaceutical interventions in three units of hospital drugs sales service belong to university hospital. Throughout the year 2013, drug problems detected were recorded prospectively and systematically. Of the 22,279 prescriptions analyzed, 247 pharmaceutical interventions (1.1%) were detected including 27.6% of problems concerning the dosages, 15.4% the unconformity, 6.9% contraindications. Regarding ATC drugs classes, we found 43.7% for anti-infectives and 17.4% for antineoplatics. The overall acceptance rate is 81.8%. These results show the importance of the analysis of outpatient prescriptions before dispensing and the need to have all prescriptions, clinical and biological elements and to develop interprofessionality. The implementation of a platform for dematerialized data exchanges between professionals, including data from the pharmaceutical patient record should contribute to improving drug management of the patient. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Yamamoto Swan, Pamela
Full Text Available Background: In 2005, Orange County California Emergency Medical Services (EMS initiated a field 12-lead program to minimize time to emergency percutaneous coronary intervention (PCI for field-identified acute myocardial infarction (MI. As the program matured, “false-positive” (defined as no PCI or coronary artery occlusion upon PCI field MI activations have been identified as a problem for the program.Objectives: To identify potentially correctable factors associated with false-positive EMS triage to PCI centers.Methods: This was a retrospective, outcome study of EMS 12-lead cases from February 2006 to June 2007. The study system exclusively used cardiac monitor internal interpretation algorithms indicating an acute myocardial infarction as the basis for triage. Indicators and variables were defined prior to the study. Data, including outcome, was from the Orange County EMS database, which included copies of 12-lead ECGs used for field triage. Negative odds ratios (OR of less than 1.0 for positive PCI were the statistical measure of interest.Results: Five hundred forty-eight patients were triaged from the field for PCI. We excluded 19 cases from the study because of death prior to PCI, refusal of PCI, and co-morbid illness (sepsis, altered consciousness that precluded PCI. Three hundred ninety-three (74.3% patients had PCI with significant coronary lesions found. False-positive field triages were associated with underlying cardiac rhythm of sinus tachycardia [OR = 0.38 (95% CI 0.23, 0.62]; atrial fibrillation [OR = 0.43 (95% CI = 0.20, 0.94]; an ECG lead not recorded [OR = 0.39 (95% CI = 0.20, 0.76]; poor ECG baseline [OR = 0.59 (95% CI = 0.25, 1.37]; One of three brands of monitors used in the field [OR = 0.35 (95% CI = 0.21, 0.59]; and female gender [OR = 0.50 (95% CI = 0.34, 0.75]. Age was not associated with false-positive triage as determined by ordinal regression (p=1.00.Conclusion: For the urban-suburban EMS field 12-lead program
Newman, Daniel S.; Salmon, Diane; Cavanaugh, Kate; Schneider, Mary Frances
Response to intervention (RtI) is an influential system of service delivery in contemporary schools, but the specific role of school consultation in RtI implementation is not clearly defined. Instructional consultation provides a potential meeting point between consultation and RtI practices. Through a mixed-methods approach, this study explored…
Behl, Diane D.; Blaiser, Kristina; Cook, Gina; Barrett, Tyson; Callow-Heusser, Catherine; Brooks, Betsy Moog; Dawson, Pamela; Quigley, Suzanne; White, Karl R.
This study sought to determine the effectiveness of telepractice as a method of delivering early intervention services to families of infants and toddlers who are deaf or hard of hearing. A comparison group design was applied to ascertain the child, family, and provider outcomes via telepractice compared with traditional in-person home visits. A…
Harrist, Christopher J.
Venka Simovska's article "Case Study of a Participatory Health-Promotion Intervention in School" provides important insights regarding the active involvement of youths in service programs. This response essay extends Simovska's discussions and frames them within three key areas: positive youth development, youth voice, and meaningful…
Riggs, Angela D.; Rosenthal, Amy R.; Smith-Bonahue, Tina
The purpose of this study was to assess the impact of a cognitive-affective intervention the attitudes, knowledge, and anticipated professional behaviors regarding homosexuality and gay and lesbian issues of pre-service teachers in the United States. Sixty-seven participants were randomly assigned either to a control group (n=34) or an…
Full Text Available Background: Early intervention (EI services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC 2011. EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA; however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community. Method: A survey sent by the National Early Childhood Technical Assistance Center (NECTAC to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs. Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified. Results: Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey. Of these, 30% (n=9 indicated that they are either currently using telehealth as an adjunct service delivery model (n=6 or plan to incorporate telehealth within the next 1-2 years (n=3. Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH, speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters. Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance. Expressed barriers and concerns for
J. Gijbels; C. van Gessel; Dr. Ir. Remko van der Lugt; Tanja Enninga; Sjoukje Sleeswijk Visser; Fenne Verhoeven; Berit Godfroij; M.M. Manschot
Service design is literally the design of services. Service designers improve existing services or design completely new ones. Nothing new so far. Services have been around for centuries, and every service was conceived and designed by someone. However, service design takes a different angle; a
Li, Suqing; Roschkov, Sylvia; Alkhodair, Abdullah; O'Neill, Blair J; Chik, Constance L; Tsuyuki, Ross T; Gyenes, Gabor T
To determine the benefits of diabetes nurse practitioner (DNP) intervention on glycemic control, quality of life and diabetes treatment satisfaction in patients with type 2 diabetes (T2DM) admitted to cardiology inpatient services at a tertiary centre. Patients admitted to the cardiology service with T2DM who had suboptimal control (HbA1c >6.5%) were approached for the study. Diabetes care was optimized by the DNP through medication review, patient education and discharge care planning. Glycemic control was evaluated with 3-month post-intervention HbA1c. Secondary outcomes of lipid profiles, quality of life and treatment satisfaction were evaluated at baseline and at 3 months with fasting lipids, Audit of Diabetes-Dependent Quality of Life questionnaires (ADDQoL) and Diabetes Treatment Satisfaction Questionnaires (DTSQ) respectively. With almost 49% of patients admitted to the Mazankowski Alberta Heart Institute having HbA1c <6.5%, only 23 patients completed the study over a 12-month period. We found a significant decrease in HbA1c values at 3 months post-intervention from 8.0% (SD=1. 2) to 6.9% (SD=0.7), p=0.002. LDL showed a significant decrease at 3 months from 1.7 mmol/L (SD=0.7) to 1.1 mmol /L (SD=0.6), p=0.011. Overall median ADDQoL impact scores improved at follow up, from -1.4 to -0.4, p = 0.0003. Overall no significant changes in DTSQ scores were seen. Short-term DNP intervention in T2DM patients admitted to the inpatient cardiology service was associated with benefits in areas of glycemic control and various domains of QoL. Our study provides support for the involvement of DNP in the care of cardiology inpatients at tertiary centres. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.
Ståhl, Christian; Toomingas, Allan; Aborg, Carl; Ekberg, Kerstin; Kjellberg, Katarina
In 2010, the Swedish government introduced a system of subsidies for occupational health (OH) service interventions, as a part in a general policy promoting early return to work. The aim of this study was to analyse the implementation of these subsidies, regarding how they were used and perceived. The study was carried out using a mixed-methods approach, and comprises material from six sub-studies: a register study of the use of the subsidies, one survey to OH service providers, one survey to employers, one document analysis of the documentation from interventions, interviews with stakeholders, and case interviews with actors involved in coordinated interventions. The subsidized services were generally perceived as positive but were modestly used. The most extensive subsidy--for coordinated interventions--was rarely used. Employers and OH service providers reported few or no effects on services and contracts. OH service providers explained the modest use in terms of already having less bureaucratic routines in place, where applying for subsidies would involve additional costs. Information about the subsidies was primarily communicated to OH service providers, while employers were not informed. The study highlights the complexity of promoting interventions through financial incentives, since their implementation requires that they are perceived by the stakeholders involved as purposeful, manageable and cost-effective. There are inherent political challenges in influencing stakeholders who act on a free market, in that the impact of policies may be limited, unless they are enforced by law.
Schulte, Bernd; O'Donnell, Amy Jane; Kastner, Sinja; Schmidt, Christiane Sybille; Schäfer, Ingo; Reimer, Jens
The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBIs) in primary health care (PHC) suggests that a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions takes place in this context. Update of two systematic reviews on ASBI effectiveness in workplaces, social service, and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in non-medical settings. We found a limited number of randomized controlled trials in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest that a stepped and carefully tailored approach is likely to be required. Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions, and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance, and potential effectiveness of ASBI for different target groups, organizational frameworks, and professionals.
Full Text Available BACKGROUND: The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBI in primary health care (PHC suggests a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions take place in this context. METHODS: Update of two systematic reviews on ASBI effectiveness in workplaces, social service and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in nonmedical settings.RESULTS: We found a limited number of randomized controlled trials (RCTs in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest a stepped and carefully tailored approach is likely to be required.DISCUSSION: Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance and potential effectiveness of ASBI for different target groups, organisational frameworks and professionals.
Yu, Eun; Sangiorgi, Daniela
This paper illustrates how, although Service Design has been described as evolving from a narrow description of a phase in New Service Development (NSD) to an approach to Service Innovation, the current Service Design research is still focused on the initial stages of NSD. Comparing existing Service Design research with foundational knowledge on NSD, the authors have proposed two complementary directions for future Service Design studies: 1) the expansion of ‘service design as a phase’ to inv...
Colla, Carrie H; Mainor, Alexander J; Hargreaves, Courtney; Sequist, Thomas; Morden, Nancy
The effectiveness of different types of interventions to reduce low-value care has been insufficiently summarized to allow for translation to practice. This article systematically reviews the literature on the effectiveness of interventions to reduce low-value care and the quality of those studies. We found that multicomponent interventions addressing both patient and clinician roles in overuse have the greatest potential to reduce low-value care. Clinical decision support and performance feedback are promising strategies with a solid evidence base, and provider education yields changes by itself and when paired with other strategies. Further research is needed on the effectiveness of pay-for-performance, insurer restrictions, and risk-sharing contracts to reduce use of low-value care. While the literature reveals important evidence on strategies used to reduce low-value care, meaningful gaps persist. More experimentation, paired with rigorous evaluation and publication, is needed.
Malla, Ashok; Iyer, Srividya; McGorry, Patrick; Cannon, Mary; Coughlan, Helen; Singh, Swaran; Jones, Peter; Joober, Ridha
The objective of this review is to report on recent developments in youth mental health incorporating all levels of severity of mental disorders encouraged by progress in the field of early intervention in psychotic disorders, research in deficiencies in the current system and social advocacy. The authors have briefly reviewed the relevant current state of knowledge, challenges and the service and research response across four countries (Australia, Ireland, the UK and Canada) currently active in the youth mental health field. Here we present information on response to principal challenges associated with improving youth mental services in each country. Australia has developed a model comprised of a distinct front-line youth mental health service (Headspace) to be implemented across the country and initially stimulated by success in early intervention in psychosis; in Ireland, Headstrong has been driven primarily through advocacy and philanthropy resulting in front-line services (Jigsaw) which are being implemented across different jurisdictions; in the UK, a limited regional response has addressed mostly problems with transition from child-adolescent to adult mental health services; and in Canada, a national multi-site research initiative involving transformation of youth mental health services has been launched with public and philanthropic funding, with the expectation that results of this study will inform implementation of a transformed model of service across the country including indigenous peoples. There is evidence that several countries are now engaged in transformation of youth mental health services and in evaluation of these initiatives.
Laing, Gregory Kenneth
There is a growing demand in higher education for universities to introduce teaching methods that achieve the learning outcomes of vocational education. The need for vocational educational outcomes was met in this study involving a service learning activity designed to provide basic professional auditing competencies. The details of the design and…
Owens, Christabel; Farrand, Paul; Darvill, Ruth; Emmens, Tobit; Hewis, Elaine; Aitken, Peter
OBJECTIVE To engage a group of people with relevant lived experience in the development of a text-messaging intervention to reduce repetition of self-harm. BACKGROUND Contact-based interventions, such as follow-up letters, postcards and telephone calls, have shown potential to reduce repetition of self-harm in those who present at Accident and Emergency departments. Text messaging offers a low-cost alternative that has not been tested. We set out to develop a text-based intervention. The process of intervention development is rarely reported and little is known about the impact of service user involvement on intervention design. METHOD We held a series of six participatory workshops and invited service users and clinicians to help us work out how to get the right message to the right person at the right time, and to simulate and test prototypes of an intervention. RESULTS Service users rejected both the idea of a generic, 'one size fits all' approach and that of 'audience segmentation', maintaining that text messages could be safe and effective only if individualized. This led us to abandon our original thinking and develop a way of supporting individuals to author their own self-efficacy messages and store them in a personal message bank for withdrawal at times of crisis. CONCLUSIONS This paper highlights both the challenge and the impact of involving consumers at the development stage. Working with those with lived experience requires openness, flexibility and a readiness to abandon or radically revise initial plans, and may have unexpected consequences for intervention design. © 2010 Blackwell Publishing Ltd.
Full Text Available The major characteristics of robots can be divided into several categories ranging from mobility to autonomy. The mobility of service robots is essential and fundamental to commercial and scientific progress. The rapid development of practical service robots depends on our decision which are the most efficient and affordable kinds of locomotion. The selection of the best locomotion, however, is not simple and easy, since the boundaries of robot working areas cannot always be defined clearly. This study emphasizes the usefulness of humanoid type service robots as general service robots, and concentrates on finding the most appropriate means of locomotion for a particular workspace. Several forms of robot locomotion were considered in three types of workspaces, and compared analytically. The results showed that three/four-wheeled robots were best suited to work in a large office or factory. Bipedal robots were suited to work in a small office or home, and quadruped robots were suited to work in outdoors. As a general alternative, bipedal locomotion seems to be the most adaptable form of locomotion for general service robots.
This study focuses on intervention processes in smallholder agriculture in the Nyanyadzi river catchment, located in Chimanimani district, Manicaland Province Zimbabwe. In particular it concerns itself with sociotechnical interventions that were implemented by Agritex, the local extension and irrigation service, in the mid-1990s. Despite a flurry of interventions and agrarian policies directed at the intensification of agricultural production and promotion of commercial agriculture in communa...
Kasari, Connie; Gulsrud, Amanda; Paparella, Tanya; Hellemann, Gerhard; Berry, Kathleen
This study compared effects of two parent-mediated interventions on joint engagement outcomes as augmentations of an early intervention program for toddlers with autism spectrum disorder (ASD). Participants included 86 toddlers (range 22-36 months) with ASD and their primary caregiver. Caregiver-child dyads were randomized to receive 10 weeks of hands-on parent training in a naturalistic, developmental behavioral intervention (joint attention, symbolic play, engagement and regulation-JASPER) or a parent-only psychoeducational intervention (PEI). Dose was controlled in terms of researcher-parent contact and early intervention services received by the child. Results yielded significant effects of the JASPER intervention on the primary outcome of joint engagement. The treatment effect was large (Cohen's f² = .69) and maintained over the 6-month follow-up. JASPER effects were also found on secondary outcomes of play diversity, highest play level achieved, and generalization to the child's classroom for child-initiated joint engagement. The PEI intervention was found to be effective in reducing parenting stress associated with child characteristics. All secondary effects were generally small to moderate. These data highlight the benefit of a brief, targeted, parent-mediated intervention on child outcomes. Future studies may consider the combination of JASPER and PEI treatments for optimal parent and child outcomes. Trial registry no. NCT00999778. (c) 2015 APA, all rights reserved).
Full Text Available Pedagogical content knowledge (PCK is generally accepted as positively impacting teaching quality and student learning. Therefore, research on PCK development in (prospective teachers is highly relevant. Based on a search in three databases (ERIC, PsycInfo, and Web of Science, a systematic review is conducted on intervention studies aiming at PCK development. The research questions are threefold: (1 How are the studies designed? (2 How are the interventions designed? and (3 What elements of interventions contribute to PCK development? The results show that most intervention studies are conducted in math and science education and use a qualitative methodology. Reflection, PCK courses, contact with other teachers, and experiences in educational practice are typically part of effective interventions. The review enables the identification of clear guidelines that may strengthen future research on stimulating PCK.
Larsen, Kristian Traberg; Huang, Tao; Ried-Larsen, Mathias
Aim: The primary aim of the study is to evaluate the effect of the Odense Overweight Intervention Study on BMI development. Methods: The OOIS is a semi-blinded randomized controlled trial with three measurement occasions. Participants were allocated into two intervention arms; a day camp...... intervention arm (DCIA) and a standard intervention arm (SIA). For the DCIA the camp lasted for six weeks and consisted of fun-based physical activities, healthy eating, and health classes. The following 10 months a family based intervention was accomplished. The SIA was offered a weekly activity session....... Conclusions: The DCIA has a clear positive health effect in key parameters; BMI, BMI z-score, body fat-%, and clustered risk. The effect is pronounced at 6 weeks and, though reduced, still present after 52 weeks. The results of the study shows the potential of an activity camp as a basis for health change...
Jones, Jannah; Wyse, Rebecca; Finch, Meghan; Lecathelinais, Christophe; Wiggers, John; Marshall, Josephine; Falkiner, Maryann; Pond, Nicole; Yoong, Sze Lin; Hollis, Jenna; Fielding, Alison; Dodds, Pennie; Clinton-McHarg, Tara; Freund, Megan; McElduff, Patrick; Gillham, Karen; Wolfenden, Luke
The primary aim of this study was to evaluate the effectiveness of an intervention to increase the implementation of healthy eating and physical activity policies and practices by centre-based childcare services. The study also sought to determine if the intervention was effective in improving child dietary intake and increasing child physical activity levels while attending childcare. A parallel group, randomised controlled trial was conducted in a sample of 128 childcare services. Intervention strategies included provision of implementation support staff, securing executive support, staff training, consensus processes, academic detailing visits, tools and resources, performance monitoring and feedback and a communications strategy. The primary outcome of the trial was the proportion of services implementing all seven healthy eating and physical activity policies and practices targeted by the intervention. Outcome data were collected via telephone surveys with nominated supervisors and room leaders at baseline and immediately post-intervention. Secondary trial outcomes included the differences between groups in the number of serves consumed by children for each food group within the Australian Guide to Healthy Eating and in the proportion of children engaged in sedentary, walking or very active physical activity assessed via observation in a random subsample of 36 services at follow-up. There was no significant difference between groups for the primary trial outcome (p = 0.44). Relative to the control group, a significantly larger proportion of intervention group services reported having a written nutrition and physical activity policy (p = 0.05) and providing adult-guided activities to develop fundamental movement skills (p = 0.01). There were no significant differences between groups at follow-up on measures of child dietary intake or physical activity. The findings of the trial were equivocal. While there was no significant difference between groups
Pirrallo, R G; Rubin, J M; Murawsky, G A
To determine how often house fires occur at 1- and 2-family dwellings visited previously by emergency medical services (EMS) personnel and whether these visits were missed opportunities for a point-of-contact home fire safety intervention. A retrospective, consecutive, case series analysis of all Milwaukee Fire Department alarm responses during 1994 was performed. Measurements included date of service, type of response, property type, dollar loss estimate, number of injuries and fatalities, cause of alarm, and presence of an operational smoke detector. Descriptive, chi2, and relative risk statistics were used to describe the relationship between EMS responses and fire responses at 1- and 2-family dwellings. The Milwaukee Fire Department dispatched 94,378 requests for service to 43,556 addresses. 16,150 addresses generated multiple requests; 7.2% (1,162/16,150) were for an "alarm of fire" response [relative risk 1.83 (95% CI: 1.69-1.99) for addresses with multiple requests vs those with a single request for service]. Most [62% (721/1,162)] of the addresses were visited by EMS personnel prior to the alarm; 28% (205/721) were 1- and 2-family dwellings. A mean of 1.8 (376/205) EMS responses occurred prior to the "alarm of fire" response; 121 addresses received 1 response, 46 received 2, 18 received 3, and 20 received > or = 4 responses. Of 169 addresses with complete data, there was a total fire dollar loss of $1,963,020 (1994) along with 32 injuries and 0 fatalities. While 47% (80/169) of the 1- and 2-family dwellings had a smoke detector present, only 17% (29/169) of the dwellings had an operational smoke detector. A point-of-contact home fire safety intervention appears of potential benefit for frequent users of EMS care. Determination of the presence of an operational smoke detector in 1- and 2-family dwellings may be a useful injury prevention act during such EMS calls.
Brady, Nancy C; Bruce, Susan; Goldman, Amy; Erickson, Karen; Mineo, Beth; Ogletree, Bill T; Paul, Diane; Romski, Mary Ann; Sevcik, Rose; Siegel, Ellin; Schoonover, Judith; Snell, Marti; Sylvester, Lorraine; Wilkinson, Krista
The National Joint Committee for the Communication Needs of People With Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities.
Malcolm, Matthew P; Roll, Marla C
The outcomes of assistive technology (AT) support services for post-secondary education students with disabilities are under-reported, and little is known about use-profiles and user experiences when AT interventions are applied to this rapidly growing population. We examined AT service outcomes related to performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure [COPM]), as well as how students with disabilities use and experience AT and AT services (employing an AT-use survey). Three-hundred fifty-three students with disabilities completed the AT-use survey, with a subset of these (n = 216) also participating with pre-post AT intervention COPM assessment. COPM performance and satisfaction ratings significantly increased from pre- to post-AT intervention in all academic task categories (reading, writing, note-taking, test-taking, and studying; p academic success, and believed they would continue using AT post-graduation. The study findings contribute to evidence-base for AT services with a hope we may improve AT services to best meet the changing needs of the growing number of college students with disabilities.
Walker, Rachel; Henderson, Amanda; Cooke, Marie; Creedy, Debra
Partnerships between university schools of nursing and health services lead to successful learning experiences for students and staff. A purposive sample of academics and students from a university school of nursing and clinicians from three health institutions involved in clinical learning (n=73) actively participated in a learning circles intervention conducted over 5 months in south east Queensland. Learning circle discussions resulted in enhanced communication and shared understanding regarding: (1) staff attitudes towards students, expectations and student assessment; (2) strategies enhancing preparation of students, mechanisms for greater support of and recognition of clinicians; (3) challenges faced by staff in the complex processes of leadership in clinical nursing education; (4) construction of learning, ideas for improving communication, networking and sharing; and (5) questioning routine practices that may not enhance student learning. Pre-post surveys of hospital staff (n=310) revealed significant differences across three sub-scales of 'accomplishment' (t=-3.98, pLearning circles can positively enhance organisational learning culture. The intervention enabled participants to recognise mutual goals. Further investigation around staff perception of their influence on their workplace is required. Copyright © 2010 Elsevier Ltd. All rights reserved.
Selph, Shelley S; Bougatsos, Christina; Blazina, Ian; Nelson, Heidi D
In 2004, the U.S. Preventive Services Task Force determined that evidence was insufficient to recommend behavioral interventions and counseling to prevent child abuse and neglect. To review new evidence on the effectiveness of behavioral interventions and counseling in health care settings for reducing child abuse and neglect and related health outcomes, as well as adverse effects of interventions. MEDLINE and PsycINFO (January 2002 to June 2012), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the second quarter of 2012), Scopus, and reference lists. English-language trials of the effectiveness of behavioral interventions and counseling and studies of any design about adverse effects. Investigators extracted data about study populations, designs, and outcomes and rated study quality using established criteria. Eleven fair-quality randomized trials of interventions and no studies of adverse effects met inclusion criteria. A trial of risk assessment and interventions for abuse and neglect in pediatric clinics for families with children aged 5 years or younger indicated reduced physical assault, Child Protective Services (CPS) reports, nonadherence to medical care, and immunization delay among screened children. Ten trials of early childhood home visitation reported reduced CPS reports, emergency department visits, hospitalizations, and self-reports of abuse and improved adherence to immunizations and well-child care, although results were inconsistent. Trials were limited by heterogeneity, low adherence, high loss to follow-up, and lack of standardized measures. Risk assessment and behavioral interventions in pediatric clinics reduced abuse and neglect outcomes for young children. Early childhood home visitation also reduced abuse and neglect, but results were inconsistent. Additional research on interventions to prevent child abuse and neglect is needed. Agency for Healthcare Research and Quality.
Landers, Ashley L; McLuckie, Alan; Cann, Robin; Shapiro, Valerie; Visintini, Sarah; MacLaurin, Bruce; Trocmé, Nico; Saini, Michael; Carrey, Normand J
Parents referred to child welfare services for child maltreatment often struggle against chronic risk factors including violence, substance abuse, mental health concerns, and poverty, which impinge upon their ability to be sensitive caregivers. The first line of intervention within the child welfare context is to modify parenting behavior. This scoping review comprehensively surveyed all available literature to map the extent and range of research activity around the types of interventions available within a child welfare context to parents of infants and toddlers (0-5 years of age), to identify the facilitators and/or barriers to the uptake of interventions, and to check that interventions match the risk factors faced by parents. This scoping review engaged in stringent screening of studies based upon inclusion/exclusion criteria. Sixty-five articles involving forty-two interventions met inclusion criteria. Interventions generally aimed to improve parenting practices, the relationship between parent and child, and/or attachment security, along with reducing child abuse and/or neglect. A notable finding of this scoping review is that at present, interventions for parents of children ages 0-5 involved with the child welfare system are most frequently measured via case study and quasi-experimental designs, with randomized control trials making up 26.2% of included study designs. Copyright © 2017 Elsevier Ltd. All rights reserved.
Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial.
Fowler, David; Hodgekins, Jo; French, Paul; Marshall, Max; Freemantle, Nick; McCrone, Paul; Everard, Linda; Lavis, Anna; Jones, Peter B; Amos, Tim; Singh, Swaran; Sharma, Vimal; Birchwood, Max
activity of 8·1 h (95% CI 2·5-13·6; p=0·0050) compared with early intervention services alone. No adverse events were deemed attributable to study therapy. Our findings show a clinically important benefit of enhanced social recovery on structured activity in patients with first-episode psychosis who received social recovery therapy plus early intervention services. Social recovery therapy might be useful in improving functional outcomes in people with first-episode psychosis, particularly in individuals not motivated to engage in existing psychosocial interventions targeting functioning, or who have comorbid difficulties preventing them from doing so. National Institute for Health Research. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
Galetzka, Mirjam; Verhoeven, J.W.M.; Pruyn, Adriaan T.H.
The purpose of this research is to add to our understanding of the antecedents of customer satisfaction by examining the effects of service reliability (Is the service “correctly” produced?) and service validity (Is the “correct” service produced?) of search, experience and credence services.
Iudici, Antonio; Gagliardo Corsi, Agnese
This article presents the availment of a new Methodology for the efficacy evaluation of interventions in the field of social science: the Method of Computerized Textual Data Analysis (M.A.D.I.T.). In the beginning, we present some elements of the international and Italian legislation referred to the efficacy evaluation and about the child protection. Subsequently this work describes the process of efficacy evaluation of an intervention of minor protection delivered by a public Italian Service, the Minor and Family Service, MiFa. The MADIT Methodology is applied to the efficacy evaluation and it is interested in discursive repertoires, defined as "a linguistically intended mode of construction of finite reality". The aim of the research is to show, through the description of every step of the implementation of the Methodology based on text analysis, how is possible to notice if there are progress in the direction of the objective of intervention of child protection. The results describes how from a starting situation of "first appearance of psychiatric career" referred to the minor, the work of the psychologist of the Service MiFa has enabled to produce a shifting in the direction of objective of the intervention, that was "developing the competence of the minor to identify objectives". Through this work, we show how a rigorous methodology for assessing effectiveness may contribute to improve the quality of service of Minor Protection and may also be suitable for new fields of social science. Copyright © 2016 Elsevier Ltd. All rights reserved.
Vyas, Amita N; Landry, Megan; Schnider, Marisa; Rojas, Angela M; Wood, Susan F
Adolescents are substantial users of short message service (SMS) and social media. The public health community now has more opportunities to reach this population with positive youth development and health messages through these media. Latinos are a growing and youthful population with significant health risks and needs. This population may benefit from SMS and social media health interventions. To examine (1) SMS and social media utilization and behavior among Latino youth, and (2) how SMS and social media can be effectively used as a component of public health interventions focused on decreasing sexual risk taking among Latino youth. A mixed-methods approach, using both quantitative survey data and qualitative interview data, was used to provide a robust understanding of SMS and social media use and behavior for public health interventions. We recruited 428 ninth and tenth grade, self-identifying Latino adolescents to participate in a quantitative survey. Additionally, we conducted five key informant interviews with staff and 15 youth. We found that 90.8% (355/391) of respondents had access to a mobile phone either through having their own or through borrowing or sharing one. Of those who had access to a mobile phone, 94.1% (334/355) used SMS, with 41.1% (113/275) sending and receiving more than 100 text messages per day. Of 395 respondents, 384 (97.2%) had at least one social media account, and the mean number of accounts was 3.0 (range 0-8). A total of 75.8% (291/384) of adolescents logged in to their account daily. Of those with a social media account, 89.1% (342/384) had a Facebook account. Youth who took the survey in English were significantly more likely than those who took it in Spanish to have access to a mobile phone (χ(2) (1 )= 5.3; 93.3% vs 86.3%; P = .02); to be high-volume texters (χ(2) (2 )= 16.8; 49.4% vs 25.3%; P social media accounts (t(387 )= 7.9; 3.41 vs 2.07; P social media are pervasive among Latino youth. Program staff and youth perceive
Dukers-Muijrers Nicole HTM
Full Text Available Abstract Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre services were integrated to provide sexual health counselling and sexually transmitted infections (STIs testing and treatment (sexual health care to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254, and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals. Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.
Wieber, Wendy B; Sumner, Lucia Quinonez
This article focuses on the use of culture-based play, songs, and games in the early education of newcomers to the United States. Current studies examine culturally inclusive practices in PreK-12 schools in America, Canada, and Australia and suggest that parents participate more enthusiastically when their cultural orientation is honored. Although there is scant research regarding in-home early intervention for infants and toddlers who are deaf or hard of hearing for recent immigrants to the ...
Guerin, Bernadette M; Payne, Deborah A; Roy, Dianne E; McPherson, Kathryn M
Little is known about the barriers and facilitators to pregnancy, birth and motherhood for disabled women within the New Zealand context. Our study explored this deficit with the aim of improving health care interventions and support for disabled mothers. This paper reports on the third phase of a mixed-methods study. The first two phases used semi-structured individual and focus group interviews with disabled women, and health professionals, involved in maternity and postnatal care and has been reported elsewhere. Phase 3 utilised a modified Delphi technique with both groups of participants to seek consensus on the prioritisation of recommendations from the study. This article focuses on the disabled women's recommendations. In all, 20 disabled women took part in the Delphi phase of the study (28% of the cohort from Phase 1). In total, 11 key recommendations were identified by the disabled women, with the top seven discussed in detail here. Health professionals and health systems could, and arguably should, utilise a matrix of these recommendations to facilitate a review of service responsiveness to disabled women. Implications for Rehabilitation Becoming a mother is a potentially relevant and important rehabilitation issue for women of childbearing age who come into contact with rehabilitation services. Disabled women encounter a range of economic, attitudinal and knowledge barriers in relation to becoming mothers. Centralised sites/sources of information have potential to provide accessible and useful information for disabled women and health professionals.
Doctor, Steven R.; Cumblidge, Stephen E.; Schuster, George J.; Hockey, Ronald L.; Abrefah, John
Studies being conducted at the Pacific Northwest National Laboratory (PNNL) in Richland, Washington are focused on assessing the effectiveness of NDE inspections of control rod drive mechanism (CRDM) nozzles and J-groove weldments. The primary objective of this work is to provide information to the United States Nuclear Regulatory Commission (US NRC) on the effectiveness of ultrasonic testing (UT) and eddy current testing (ET) as related to the in-service inspection of CRDM nozzles and J-groove weldments, and to enhance the knowledge base of primary water stress corrosion cracking (PWSCC) through destructive characterization of the CRDM assemblies. In describing two CRDM assemblies removed from service, decontaminated, and then used in a series of NDE measurements, this paper will address the following questions: 1) What did each technique detect?, 2) What did each technique miss?, 3) How accurately did each technique characterize the detected flaws? Two CRDM assemblies including the CRDM nozzle, the J-groove weld, buttering, and a portion of the ferritic head material were selected for this study. One contained suspected PWSCC, based on in-service inspection data; the other contained evidence suggesting through-wall leakage, but this was unconfirmed. The selected NDE measurements follow standard industry techniques for conducting in-service inspections of CRDM nozzles and the crown of the J-groove welds and buttering. In addition, laboratory based NDE methods will be employed to conduct inspections of the CRDM assemblies, with particular emphasis on inspecting the J-groove weld and buttering. This paper will also describe the NDE methods used and discus the NDE results. Future work will involve using the results from these NDE studies to guide the development of a destructive characterization plan to reveal the crack morphology, to be compared with NDE responses.
Phoenix, Michelle; Rosenbaum, Peter
Several concepts - risk, resilience, disability and hard-to-reach families in early intervention services - are talked and written about in many ways. Family Stress Theory can be usefully applied to explore these issues systematically. The relationship between risk and disability is complex, and the role of resilience is not fully understood. The idea of "hard-to-reach families" is not well defined, thus presenting challenges to service providers and policy makers. Reflection: This paper presents the Model of Risk, Disability and Hard-to-Reach Families and uses the model to: (1) define the groups of high risk families and families of children with disabilities and explore the concept of resilience within these groups; (2) describe services offered to these groups; and (3) reflect on service use and so-called "hard-to-reach families". Each section includes suggested applications for service providers that may inform the work done with young children and their families who experience risk or disability. Service providers can apply the Model of Risk, Disability and Hard-to-Reach Families to consider each family's unique strengths and challenges, and use those individual elements to influence service recommendations and anticipate service use. Implications for rehabilitation The concepts of risk, resilience, and hard-to-reach families are poorly defined in the literatures, but have important implications with respect to early childhood intervention services. Family Stress Theory can help to identify high-risk families and account for family resilience It is important for clinicians, researchers and policy makers to consider the relationship between disability and risk with respect to services offered to families and the potential barriers to service use. Clinicians and policy makers have a role in promoting accessible early childhood services.
Lu, Wang-sheng; Xu, Wu-yi; Zhang, Jing; Liu, Da; Wang, Da-min; Jia, Po; Li, Zhi-cao; Wang, Tian-miao; Zhang, Da-peng; Tian, Zeng-min; Zeng, Yanjun
Based on the background of minimally invasive surgery and applications of medical robots, a vascular interventional robotic system has been developed that can be used in the field of vascular intervention. The robotic system comprises a propulsion system, an image navigation system and a virtual surgery training system. Integration of the three systems constitutes a vascular intervention prototype robotic system used to carry out in vitro vascular intervention and animal experiments. On a transparent glass vascular model, a catheter was shown to enter an arbitrary branch of the vascular model with catheter motion meeting the requirements of clinical vascular intervention surgery (VIS); i.e. error band of catheter motion experiments, 1.33-2.00 mm (4F-6F) diameter catheters were selectively inserted successfully into predefined targets in the animal, such as the renal, cardiovascular and cerebrovascular artery. Compared with conventional manual surgery, the time for robotic surgery is a little longer. There were no operative complications in the animal experiments. These simulation and animal study results demonstrate that this vascular interventional robotic system allows doctors to perform angiography remotely and prevents them from radiation exposure. The system may be the basis for further clinical applications of vascular intervention. Copyright © 2011 John Wiley & Sons, Ltd.
Søgaard, Rikke; Sørensen, Jan; Waldorff, Frans B; Eckermann, Ane; Buss, Dorte V; Phung, Kieu T T; Waldemar, Gunhild
To assess the cost utility of early psychosocial intervention for patients with Alzheimer's disease and their primary caregivers. Cost utility evaluation alongside a multicentre, randomised controlled trial with 3 years of follow-up. Primary care and memory clinics in five Danish districts. 330 community-dwelling patients and their primary caregivers. Psychosocial counselling and support lasting 8-12 months after diagnosis and follow-up at 3, 6, 12 and 36 months in the intervention group or follow-up only in the control group. The primary outcome measure was the cost of additional quality-adjusted life years (QALYs). Costs were measured from a societal perspective, including the costs of healthcare, social care, informal care and production loss. QALYs were estimated separately for the patient and the caregiver before aggregation for the main analysis. None of the observed cost and QALY measures were significantly different between the intervention and control groups, although a tendency was noted for psychosocial care leading to cost increases with informal care that was not outweighed by the tendency for cost savings with formal care. The probability of psychosocial intervention being cost-effective did not exceed 36% for any threshold value. The alternative scenario analysis showed that the probability of cost-effectiveness increased over the range of threshold values used if the cost perspective was restricted to formal healthcare. A multifaceted, psychosocial intervention programme was found unlikely to be cost-effective from a societal perspective. The recommendation for practice in settings that are similar to the Danish setting is to provide follow-up with referral to available local support programmes when needed, and to restrict large multifaceted intervention programmes to patients and caregivers with special needs until further evidence for cost-effectiveness emerges. The study was registered in the Clinical Trial Database as ISRCTN74848736.
Yska, Jan Peter; Gertsen, Sanneke; Flapper, Gerbrich; Emous, Marloes; Wilffert, Bob; van Roon, Eric N
Use of nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided in bariatric surgery patients. If use of an NSAID is inevitable, a proton pump inhibitor (PPI) should also be used. To determine the effect of an, compared to care-as-usual, additional intervention to reduce NSAID use in patients who underwent bariatric surgery, and to determine the use of PPIs in patients who use NSAIDs after bariatric surgery. A randomized controlled intervention study in patients after bariatric surgery. Patients were randomized to an intervention or a control group. The intervention consisted of sending a letter to patients and their general practitioners on the risks of use of NSAIDs after bariatric surgery and the importance of avoiding NSAID use. The control group received care-as-usual. Dispensing data of NSAIDs and PPIs were collected from patients' pharmacies: from a period of 6 months before and from 3 until 9 months after the intervention. Two hundred forty-eight patients were included (intervention group: 124; control group: 124). The number of users of NSAIDs decreased from 22 to 18 % in the intervention group and increased from 20 to 21 % in the control group (NS). The use of a PPI with an NSAID rose from 52 to 55 % in the intervention group, and from 52 to 69 % in the control group (NS). Informing patients and their general practitioners by letter, in addition to care-as-usual, is not an effective intervention to reduce the use of NSAIDs after bariatric surgery (trial number NTR3665).
William J. Sutherland
Full Text Available The major task of policy makers and practitioners when confronted with a resource management problem is to decide on the potential solution(s to adopt from a range of available options. However, this process is unlikely to be successful and cost effective without access to an independently verified and comprehensive available list of options. There is currently burgeoning interest in ecosystem services and quantitative assessments of their importance and value. Recognition of the value of ecosystem services to human well-being represents an increasingly important argument for protecting and restoring the natural environment, alongside the moral and ethical justifications for conservation. As well as understanding the benefits of ecosystem services, it is also important to synthesize the practical interventions that are capable of maintaining and/or enhancing these services. Apart from pest regulation, pollination, and global climate regulation, this type of exercise has attracted relatively little attention. Through a systematic consultation exercise, we identify a candidate list of 296 possible interventions across the main regulating services of air quality regulation, climate regulation, water flow regulation, erosion regulation, water purification and waste treatment, disease regulation, pest regulation, pollination and natural hazard regulation. The range of interventions differs greatly between habitats and services depending upon the ease of manipulation and the level of research intensity. Some interventions have the potential to deliver benefits across a range of regulating services, especially those that reduce soil loss and maintain forest cover. Synthesis and applications: Solution scanning is important for questioning existing knowledge and identifying the range of options available to researchers and practitioners, as well as serving as the necessary basis for assessing cost effectiveness and guiding implementation strategies. We
Carlos K. H. Wong
Full Text Available Aims. To investigate the costs and cost-effectiveness of a short message service (SMS intervention to prevent the onset of type 2 diabetes mellitus (T2DM in subjects with impaired glucose tolerance (IGT. Methods. A Markov model was developed to simulate the cost and effectiveness outcomes of the SMS intervention and usual clinical practice from the health provider’s perspective. The direct programme costs and the two-year SMS intervention costs were evaluated in subjects with IGT. All costs were expressed in 2011 US dollars. The incremental cost-effectiveness ratio was calculated as cost per T2DM onset prevented, cost per life year gained, and cost per quality adjusted life year (QALY gained. Results. Within the two-year trial period, the net intervention cost of the SMS group was $42.03 per subject. The SMS intervention managed to reduce 5.05% onset of diabetes, resulting in saving $118.39 per subject over two years. In the lifetime model, the SMS intervention dominated the control by gaining an additional 0.071 QALY and saving $1020.35 per person. The SMS intervention remained dominant in all sensitivity analyses. Conclusions. The SMS intervention for IGT subjects had the superiority of lower monetary cost and a considerable improvement in preventing or delaying the T2DM onset. This trial is registered with ClinicalTrials.gov NCT01556880.
Paavonen, E Juulia; Huurre, Taina; Tilli, Maija; Kiviruusu, Olli; Partonen, Timo
Sleep disturbances are common among adolescents, but there are no brief interventions to treat them. The objective of this study was to evaluate the effectiveness of a brief semistructured, individually delivered sleep intervention to ameliorate adolescents' sleeping difficulties and lengthen sleep duration. All students aged 16-18 years in a high school were screened for sleeping difficulties and 36 students with the highest sleep problem scores were invited to the intervention. Postintervention improvements were observed on self-reported and actiwatch-registered sleep duration, self-reported sleep quality and sleep latency, perceived stress and anxiety (all p values sleep efficiency and sleep latency did not change (p > 0.05). A brief individual sleep intervention can be effective in lengthening sleep duration and improving subjective sleep quality and well-being among adolescents.
Doering, Jennifer J; Dogan, Sirin
The purpose of this pilot study was to evaluate the feasibility, acceptability, and cost of a self-management intervention for postpartum fatigue and sleep in socioeconomically disadvantaged urban women. Helping U Get Sleep (HUGS) is a theory-guided intervention developed from the Individual and Family Self-Management Theory. Medicaid-enrolled participants in the United States were recruited from an inpatient postpartum unit. Treatment and attention control interventions were delivered (15 HUGS, 12 comparison) at a week 3 postpartum home visit and 4 follow-up phone calls. Over the 9-week protocol, the HUGS group demonstrated significant improvements in subjective fatigue and subjective sleep disturbance relative to the comparison group. The HUGS intervention was feasible and acceptable, delivered on average, in 100 min and costing US$79 per participant.
Guler, Jessy; de Vries, Petrus J; Seris, Noleen; Shabalala, Nokuthula; Franz, Lauren
The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.
Rajeev Sharma; Bright Keswani
The purpose of this research paper is to explore the knowledge of the existing studies related to cloud computing current trend. The outcome of my work will be demonstrated in the form of diagram which will exemplify the ERP integration process for in-house and cloud eco-system. It will provide a conceptual view to the new client or entrepreneurs using ERP services and explain them how to deal with two stages of ERP systems (cloud and in-house). Also suggest how to improve knowledge ...
Weinberger, Morris; Murray, Michael D; Marrero, David G; Brewer, Nancy; Lykens, Michael; Harris, Lisa E; Newell, A Jeffrey; Collins, Joyce; Tierney, William M
To describe unexpected challenges and strategies to overcome them when conducting randomized controlled trials (RCT) of health services research interventions in retail pharmacies. Thirty-six retail drug stores in Indianapolis. We conducted an RCT to evaluate the effectiveness of an intervention to increase pharmacists' involvement in caring for customers. We describe: (1) our RCT as originally designed, (2) unexpected challenges we faced; and (3) how we resolved those challenges. Randomized controlled trial. Major modifications in research design were necessitated by factors such as corporate restructuring, heightened sensitivity to patient confidentiality, and difficulties altering employees' behavior. We overcame these barriers by conducting research that is consistent with corporate goals, involving appropriate corporate administrators and technical personnel early in the process, and being flexible. Health services researchers should conduct RCTs in a variety of non-academic practice settings to increase generalizability and better reflect the true impact of interventions. Pragmatic problems, although significant, can be successfully overcome.
Cabezas, Carmen; Advani, Mamta; Puente, Diana; Rodriguez-Blanco, Teresa; Martin, Carlos
To evaluate the effectiveness in primary care of a stepped smoking cessation intervention based on the transtheoretical model of change. Cluster randomized trial; unit of randomization: basic care unit (family physician and nurse who care for the same group of patients); and intention-to-treat analysis. All interested basic care units (n = 176) that worked in 82 primary care centres belonging to the Spanish Preventive Services and Health Promotion Research Network in 13 regions of Spain. A total of 2,827 smokers (aged 14-85 years) who consulted a primary care centre for any reason, provided written informed consent and had valid interviews. The outcome variable was the 1-year continuous abstinence rate at the 2-year follow-up. The main variable was the study group (intervention/control). Intervention involved 6-month implementation of recommendations from a Clinical Practice Guideline which included brief motivational interviews for smokers at the precontemplation-contemplation stage, brief intervention for smokers in preparation-action who do not want help, intensive intervention with pharmacotherapy for smokers in preparation-action who want help and reinforcing intervention in the maintenance stage. Control group involved usual care. Among others, characteristics of tobacco use and motivation to quit variables were also collected. The 1-year continuous abstinence rate at the 2-year follow-up was 8.1% in the intervention group and 5.8% in the control group (P = 0.014). In the multivariate logistic regression, the odds of quitting of the intervention versus control group was 1.50 (95% confidence interval = 1.05-2.14). A stepped smoking cessation intervention based on the transtheoretical model significantly increased smoking abstinence at a 2-year follow-up among smokers visiting primary care centres. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.
Poduska, Jeanne M; Kellam, Sheppard G; Wang, Wei; Brown, C Hendricks; Ialongo, Nicholas S; Toyinbo, Peter
The Good Behavior Game (GBG) is a classroom behavior management strategy focused on socializing children to the role of student and aimed at reducing early aggressive, disruptive behavior, a confirmed antecedent to service use. The GBG was tested in a randomized field trial in 19 elementary schools with two cohorts of children as they attended first and second grades. This article reports on the impact of the GBG on service use through young adulthood. Three or four schools in each of five urban areas were matched and randomly assigned to one of three conditions: (1) GBG, (2) an intervention aimed at academic achievement, or (3) the standard program of the school system. Children were assigned to classrooms to ensure balance, and teachers and classrooms were randomly assigned to intervention conditions. This study provides evidence of a positive impact of a universal preventive intervention on later service use by males, although not by females, for problems with emotions, behavior, or drugs or alcohol. For both cohorts, males in GBG classrooms who had been rated as highly aggressive, disruptive by their teachers in the fall of first grade had a lower rate of school-based service use than their counterparts in control classrooms. REPLICATION: The design employed two cohorts of students. Although both first- and second-grade teachers received less training and support with the second cohorts of students than with the first cohort, the impact of GBG was similar across both cohorts.
Nøst, Torunn Hatlen; Steinsbekk, Aslak; Riseth, Liv; Bratås, Ola; Grønning, Kjersti
People with chronic pain use a range of healthcare services, but they also report a high degree of dissatisfaction with treatments. One reason for dissatisfaction might be participants' expectations towards treatments. The aim of this study was to explore expectations of people with chronic pain towards participation in easily accessible pain management interventions delivered in public primary care. A qualitative study using semi-structured individual face-to-face interviews with 21 informants. The informants were recruited among participants enrolled in a randomised controlled trial on the effect of an easily accessible self-management course for people with chronic pain. The data were analysed thematically using Systematic Text Condensation. Having experienced pain for a long time, there was no specific expectation of a cure or a significant alleviation of the pain. The informants' expectations mainly concerned a hope that participation could lead to a better everyday life. The informants said that hope was important as it motivated them to keep going and continue self-care activities. The hope acted as a driving force towards trying new interventions and maintaining motivation to do activities they experienced as beneficial. Both concrete aspects of the current intervention and an understanding of what interventions in general could offer contributed to the informants hope. The expectations centred about the interventions being something new, as they had not previously tried this service, an opportunity to gain and reinforce skills, to help them continue to grow as a person, to meet others in similar situations, and to access professional support in an easy manner. Participating in interventions provided by healthcare services was seen by some as an act of self-care, where they did something active to manage their health. Expectations towards the interventions were related to a hope for participation leading to a better everyday life. The role of hope for
Torunn Hatlen Nøst
Full Text Available Abstract Background People with chronic pain use a range of healthcare services, but they also report a high degree of dissatisfaction with treatments. One reason for dissatisfaction might be participants’ expectations towards treatments. The aim of this study was to explore expectations of people with chronic pain towards participation in easily accessible pain management interventions delivered in public primary care. Methods A qualitative study using semi-structured individual face-to-face interviews with 21 informants. The informants were recruited among participants enrolled in a randomised controlled trial on the effect of an easily accessible self-management course for people with chronic pain. The data were analysed thematically using Systematic Text Condensation. Results Having experienced pain for a long time, there was no specific expectation of a cure or a significant alleviation of the pain. The informants’ expectations mainly concerned a hope that participation could lead to a better everyday life. The informants said that hope was important as it motivated them to keep going and continue self-care activities. The hope acted as a driving force towards trying new interventions and maintaining motivation to do activities they experienced as beneficial. Both concrete aspects of the current intervention and an understanding of what interventions in general could offer contributed to the informants hope. The expectations centred about the interventions being something new, as they had not previously tried this service, an opportunity to gain and reinforce skills, to help them continue to grow as a person, to meet others in similar situations, and to access professional support in an easy manner. Participating in interventions provided by healthcare services was seen by some as an act of self-care, where they did something active to manage their health. Conclusions Expectations towards the interventions were related to a hope for
Khan, Natasha S; Norman, Ian J; Dhital, Ranjita; McCrone, Paul; Milligan, Peter; Whittlesea, Cate M
Studies indicate that community pharmacy-based alcohol brief intervention (BI) is feasible. However, few studies report significant reductions in post-BI alcohol consumption and customer experience. Cost-effectiveness has not been previously examined. This 5 month study adopted a single group pre- and post-experimental design to: (1) assess uptake of the community pharmacy alcohol BI service; (2) establish post-BI changes in alcohol consumption for hazardous drinkers; (3) report the acceptability of the service to customers who received it; and (4) undertake a preliminary economic evaluation of the service through establishing whether pharmacy-based alcohol BI affected health and social care costs, including lost employment costs, and whether it was cost-effective. 26 community pharmacies in south London, UK. Trained pharmacists used the AUDIT-C and a retrospective 7-day Drinking Diary to identify risky drinkers and inform feedback and advice. Harmful drinkers were referred to their general practitioner and/or specialist alcohol services. A confidential service feedback questionnaire was completed by alcohol BI recipients. Baseline and 3-month follow-up telephone interviews were conducted with hazardous and low risk drinkers to assess post-BI alcohol use change and service cost-effectiveness. AUDIT-C, 7-day alcohol unit consumption, drinking days, cost utilisation data. Of the 663 eligible customers offered alcohol BI, 141 (21 %) took up the service. Three-quarters of customers were identified as risky drinkers. Follow-up interviews were conducted with 61 hazardous/low risk drinkers (response rate = 58 %). Hazardous drinkers were found to significantly reduce their 7-day alcohol unit consumption and drinking days, but not AUDIT-C scores. The majority of harmful drinkers (91 %, n = 10) who were contactable post-BI had accessed further alcohol related services. Customer feedback was generally positive. Over 75 % of customers would recommend the service to others. The
Hurt, Lisa; Paranjothy, Shantini; Lucas, Patricia Jane; Watson, Debbie; Mann, Mala; Griffiths, Lucy J; Ginja, Samuel; Paljarvi, Tapio; Williams, Jo; Bellis, Mark A; Lingam, Raghu
Experiences in the first 1000 days of life have a critical influence on child development and health. Health services that provide support for families need evidence about how best to improve their provision. We systematically reviewed the evidence for interventions in high-income countries to improve child development by enhancing health service contact with parents from the antenatal period to 24 months postpartum. We searched 15 databases and trial registers for studies published in any language between 01 January 1996 and 01 April 2016. We also searched 58 programme or organisation websites and the electronic table of contents of eight journals. Primary outcomes were motor, cognitive and language development, and social-emotional well-being measured to 39 months of age (to allow the interventions time to produce demonstrable effects). Results were reported using narrative synthesis due to the variation in study populations, intervention design and outcome measurement. 22 of the 12 986 studies identified met eligibility criteria. Using Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group criteria, the quality of evidence overall was moderate to low. There was limited evidence for intervention effectiveness: positive effects were seen in 1/6 studies for motor development, 4/11 for language development, 4/8 for cognitive development and 3/19 for social-emotional well-being. However, most studies showing positive effects were at high/unclear risk of bias, within-study effects were inconsistent and negative effects were also seen. Intervention content and intensity varied greatly, but this was not associated with effectiveness. There is insufficient evidence that interventions currently available to enhance health service contacts up to 24 months postpartum are effective for improving child development. There is an urgent need for robust evaluation of existing interventions and to develop and evaluate novel interventions to enhance
Marteau Theresa M
Full Text Available Abstract Background General practitioners' (GPs negative beliefs about smoking cessation services may act as barriers to them recommending such services to smokers motivated to stop smoking. Methods In Study 1, 25 GPs from 16 practices across London were interviewed in this qualitative study. Framework analysis was used to identify key themes in GPs' beliefs about smoking cessation services. In Study 2, a convenience sample of 367 GPs completed an internet-based survey. Path-analysis was used to examine relationships between beliefs identified in Study 1 and intentions to recommend smoking cessation services. Results In Study 1, GPs felt that smoking cessation assistance was best provided by others. GPs favoured local services (i.e. practice nurses offering stop smoking support over central services (i.e. offered through the Primary Care Trust, mainly because these were seen as more personalised and accessible for patients. These beliefs appeared to influence GPs' beliefs about the effectiveness of services. In Study 2, GPs' beliefs had a large effect on their intentions to recommend both central services, (f2 = .79 and local services, (f2 = 1.04. GPs' beliefs about effectiveness and cost-effectiveness were key predictors their intentions to recommend central services and local services. Beliefs about the level of personalisation offered and smokers' likelihood of attending services had indirect effects on intentions to recommend services operating via beliefs about effectiveness. Conclusion GPs vary in their perceptions of the effectiveness of smoking cessation services and their intentions to recommend these services vary in line with these beliefs. Interventions aimed at increasing the likelihood with which GPs recommend these services may therefore be more effective if they addressed these beliefs.
Hooker, Gillian W.; Babu, D; Myers, MF; Zierhut, H; McAllister, M
As the demand for evidence to support the value of genetic counseling increases, it is critical that reporting of genetic counseling interventions in research and other types of studies (e.g. process improvement or service evaluation studies) adopt greater rigor. As in other areas of healthcare, the appraisal, synthesis, and translation of research findings into genetic counseling practice are likely to be improved if clear specifications of genetic counseling interventions are reported when ...
Waldemar, G.; Waldorff, F.B.; Buss, D.V.
There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline characteristics...
Edalat, Faramarz; Lindquester, Will S; Gill, Anne E; Simoneaux, Stephen F; Gaines, Jennifer; Hawkins, C Matthew
Despite a continuing emphasis on evaluation and management clinical services in adult interventional radiology (IR) practice, the peer-reviewed literature addressing these services - and their potential economic benefits - is lacking in pediatric IR practice. To measure the effects of expanding evaluation and management (E&M) services through the establishment of a dedicated pediatric interventional radiology outpatient clinic and inpatient E&M reporting system. We collected and analyzed E&M current procedural terminology (CPT) codes from all patients seen in a pediatric interventional radiology outpatient clinic between November 2014 and August 2015. We also calculated the number of new patients seen in the clinic who had a subsequent procedure (procedural conversion rate). For comparison, we used historical data comprising pediatric patients seen in a general interventional radiology (IR) clinic for the 2 years immediately prior. An inpatient E&M reporting system was implemented and all inpatient E&M (and subsequent procedural) services between July 2015 and September 2015 were collected and analyzed. We estimated revenue for both outpatient and inpatient services using the Medicare Physician Fee Schedule global non-facility price as a surrogate. Following inception of a pediatric IR clinic, the number of new outpatients (5.5/month; +112%), procedural conversion rate (74.5%; +19%), estimated E&M revenue (+158%), and estimated procedural revenue from new outpatients (+228%) all increased. Following implementation of an inpatient clinic reporting system, there were 8.3 consults and 7.3 subsequent hospital encounters per month, with a procedural conversion rate of 88%. Growth was observed in all meaningful metrics following expansion of outpatient and inpatient pediatric IR E&M services.
Paynter, Jessica M.; Ferguson, Sarah; Fordyce, Kathryn; Joosten, Annette; Paku, Sofia; Stephens, Miranda; Trembath, David; Keen, Deb
A number of autism intervention practices have been demonstrated to be effective. However, the use of unsupported practices persists in community early intervention settings. Recent research has suggested that personal, professional and workplace factors may influence intervention choices. The aim of this research was to investigate knowledge and…
Vicente-Herrero, Teofila; Burke, Thomas A; Laínez, Miguel J A
Migraine is associated with a significant productivity loss to employers, who may benefit from making a migraine intervention available to their employees. To evaluate changes in migraine-related productivity and non-workplace impairment associated with a migraine intervention program from the employer perspective. This was a pre-test post-test study of Spanish Postal Service employees with migraine. The intervention consisted of counseling from occupational health physicians and rizatriptan 10 mg for symptomatic treatment of two subsequent migraine headaches. Physicians also prescribed additional medications for migraine prophylaxis, treatment of tension headaches, and rescue medications. Migraine-related work loss and non-workplace impairment (interference with daily and social activities) were self-reported at baseline (pre-intervention) and separately following each migraine headache (post-intervention) with the aid of a diary. Migraine-related work loss was reported as work loss due to absenteeism, reduced productivity while at work, and the sum of the two (total lost work day equivalents [LWDE]). An employer perspective was taken for the cost analysis, and thus productivity costs were the only costs considered. A total of 436 patients comprised the population for analysis. The number of migraine-related LWDE per migraine attack were 0.48 days per migraine headache in the month before the intervention, decreasing to 0.20 days and 0.07 days per migraine headache during the first and second migraine headaches following the intervention (p productivity costs per migraine headache were 34 euros/patient before the intervention, decreasing to 14 euros/patient and 5 euros/patient during the first and second headaches following the intervention (p employees reduce the burden of migraine.
Arnold, Benjamin Ford
This dissertation presents a quasi-experimental study design to evaluate non-random\\-ized, pre-existing community interventions not originally designed to gather rigorous data about sustainability and impact. The core components of the design include selection of a control group using propensity score matching with pre-intervention (baseline) secondary data and post-intervention follow-up in the field. The main advantages of the design include measurement of interventions implemented under ac...
Lahtela, Antti; Jäntti, Marko
IT services and IT service management play a very important role in the today's IT industry. Software as service approach enables IT customers to focus on using the software while IT service providers take care of the installation, configuration, support and maintenance activities. Various process frameworks can be used to improve IT service management processes. The most widely used IT service management framework is the IT Infrastructure Library (ITIL) that provides best practices for IT service providers on how to design, manage and support IT services. Despite the IT service management process frameworks, implementing an effective service support interface between an IT service provider and an IT customer is a big challenge. The research problem in this study is: what types of challenges are related to the service support interface between an IT service provider and IT customers. The main contribution of this paper is present challenges in a service support interface identified during a case study with a large IT service provider company in Finland.
Watkins, Amanda L; Dodgson, Joan E
The purpose of this synthesis was to review intervention studies that focused on increasing the breastfeeding knowledge, self-confidence, and supportive behaviors of healthcare professionals. Fourteen articles were identified through database searches as the basis for this review. Breastfeeding education can be effective in increasing the knowledge and confidence of nurses. Duration and exclusivity rates for breastfeeding may also be improved. Improving nurses' knowledge of breastfeeding is a modifiable factor that is important in supporting a mother in her decision to breastfeed.
Lornudd, Caroline; Bergman, David; Sandahl, Christer; von Thiele Schwarz, Ulrica
Purpose The purpose of this paper was to assess two different leader development interventions by comparing their effects on leadership behaviour and evaluating their combined impact after two years, from the viewpoints of both the participating managers and external raters. Design/methodology/approach The study was a longitudinal randomised controlled trial with a cross-over design. Health care managers ( n = 177) were first randomised to either of two 10-month interventions and a year later were switched to the other intervention. Leadership behaviour was rated at pre-test and 12 and 24 months by participating managers and their superiors, colleagues and subordinates using a 360-degree instrument. Analysis of variance and multilevel regression analysis was performed. Findings No difference in effect on leadership behaviour was found between the two interventions. The evaluation of the combined effect of the interventions on leadership behaviour showed inconsistent (i.e. both increased and decreased) ratings by the various rater sources. Practical implications This study provides some evidence that participation in leadership development programmes can improve managers' leadership behaviours, but the results also highlight the interpretive challenges connected with using a 360-degree instrument to evaluate such development. Originality/value The longitudinal randomised controlled design and the large sample comprising both managers and external raters make this study unusually rigorous in the field of leadership development evaluations.
Kuerschner, Ekkehard; Diehl, Eva; Hermann-Friede, Janek; Hornikel, Christiane; Rosenbusch, Joscha; Sagmeister, Elias
Improved energy supply is essential for socio-economic development and environmental sustainability. It has a direct impact on the life situation of the rural poor, influencing their productivity, health, education, and gender-related issues. The present report compiles the findings of a study carried out on behalf of the sector project Poverty-Oriented Basic Energy Services of the German Technical Cooperation in collaboration with the Sustainable Energy for Development Programme in Bangladesh. The contribution under consideration assessed the impacts and the poverty orientation of both the Solar Home System and the Improved Cook Stoves interventions as well as the sustainability of the dissemination structures for these technologies. Access to solar electricity was found to enhance the general life quality of Solar Home System owners, a great majority of whom named improved lighting as the most important benefit. Improved study conditions for children and more customers are related benefits that were classified as second most important by domestic and commercial users, respectively. Recommendations given with respect to the Solar House System intervention include minor reconsiderations of how grants shall be targeted and phased out, as well as how different local capacity building measures are better geared towards enhancing user satisfaction, creating job opportunities and improving the local availability of Solar House Systems supply and know-how. The study suggests the establishment of result-oriented monitoring involving an exchange between Solar House System users and providers, enabling the latter to assess their own institutional development. Moreover, the study advises the maintenance of the current hire-purchase model but also the development of more flexible pro-poor payment for Solar House System batteries combined with a strengthening of incentives for recycling.
A 3-year study of 46 textile industry workers identified causes of employee turnover (supervision, training, organizational communication) using performance analysis. A study of multiple interventions based on the analysis resulted in changes in orientation procedures, organizational leadership, and climate, reducing turnover by 24%. (SK)
ABSTRACT. The best way to analyze drug utilization and evaluate impact of an intervention in health care institutions is to study the universal indicators, which are not dependent either on investigator or time of measurement. The aim of this study was to characterize the prescription pattern of public health institutions in ...
Chmitorz, A; Kunzler, A; Helmreich, I; Tüscher, O; Kalisch, R; Kubiak, T; Wessa, M; Lieb, K
Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major problems are the use of definitions of resilience as trait or a composite of resilience factors, the use of unsuited assessment instruments, and inappropriate study designs. To overcome these challenges, we propose 1) an outcome-oriented definition of resilience, 2) an outcome-oriented assessment of resilience as change in mental health in relation to stressor load, and 3) methodological standards for suitable study designs of future intervention studies. Our proposals may contribute to an improved quality of resilience intervention studies and may stimulate further progress in this growing research field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Fox, Amanda; Gardner, Glenn; Osborne, Sonya
This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, ). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. © 2017 John Wiley & Sons Ltd.
Thomas, Elizabeth C; Salzer, Mark S
The working alliance between non-peer providers and mental health consumers is associated with positive outcomes. It is hypothesized that this factor, in addition to other active support elements, is also positively related to peer support service outcomes. This study evaluates correlates of the peer-to-peer relationship and its unique association with service satisfaction and recovery-oriented outcomes. Participants were 46 adults with serious mental illnesses taking part in a peer-brokered self-directed care intervention. Pearson correlation analyses examined associations among peer relationship factors, services-related variables and recovery-oriented outcomes (i.e. empowerment, recovery and quality of life). Hierarchical multiple regression analyses evaluated associations between relationship factors and outcomes over time, controlling for other possible intervention effects. The peer relationship was not related to number of contacts. There were robust associations between the peer relationship and service satisfaction and some recovery-oriented outcomes at 24-months, but not at 12-months. These associations were not explained by other possible intervention effects. This study contributes to a better understanding of the positive, unique association between the peer-to-peer relationship and outcomes, similar to what is found in non-peer-delivered interventions. Implications for program administrators and policymakers seeking to integrate peer specialists into mental health service systems are discussed.
DeVoe, Ellen R; Paris, Ruth; Emmert-Aronson, Ben; Ross, Abigail; Acker, Michelle
Parenting through the deployment cycle presents unique stressors for military families. To date, few evidence-based and military-specific parenting programs are available to support parenting through cycles of deployment separation and reintegration, especially for National Guard/Reserve members. The purpose of this research was to test the efficacy of a parenting program developed specifically to support military families during reintegration. Within 1 year of returning from deployment to Afghanistan or Iraq, 115 service members with very young children were randomly assigned to receive either the Strong Families Strong Forces Parenting Program at baseline or after a 12-week waiting period. Using a home-based modality, service members, at-home parents, and their young child were assessed at baseline, 3 months posttreatment/wait period, and 6 months from baseline. Service member parents in Strong Families evidenced greater reductions in parenting stress and mental health distress relative to those in the waitlist comparison group. Service members with more posttraumatic stress symptoms reported higher levels of perceived parental efficacy in the intervention group than service members in the comparison group. Intervention also resulted in enhanced parental reflective capacity, including increased curiosity and interest in the young child among those in the intervention group relative to comparison. Service member parents and their spouses demonstrated high interest in participating in a postdeployment parenting program targeting families with very young children. Findings point to the feasibility, appeal, and efficacy of Strong Families in this initial trial and suggest promise for implementation in broader military and community service systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Schneider, Julie; Dunsmore, Moira; McMahon, Catherine M; Gopinath, Bamini; Kifley, Annette; Mitchell, Paul; Leeder, Stephen R; Wang, Jie Jin
The aims of this study were to investigate the potential unmet need for hearing services among older people attending low-vision rehabilitation, and pilot a "Hearing Screening and Education Model" (HSEM) of intervention to promote use of hearing services and aids among these individuals. In the Vision-Hearing project, 300 clients attending low-vision clinics in Sydney, Australia, participated in baseline interviews and the HSEM (2010-2011). The HSEM consisted of: (1) standard pure-tone audiometry; (2) discussion of hearing loss and implications of dual sensory impairment; and (3) provision of information on hearing services and facilitated referral. Those with hearing loss who did not own hearing aids, reported low use (day), or used a single aid with bilateral loss were referred for full assessment by an audiologist and to the follow-up arm of the study (n = 210). Follow-up interviews were conducted within 12 months to ascertain actions taken and audiological and other health outcomes. Of 169 participants in the follow-up study, 68 (40.2%) sought help for hearing loss within 12 months. Help-seekers had higher mean hearing handicap scores at baseline compared with non-help-seekers. The majority of help-seekers (85.3%) underwent a complete hearing assessment. Fifty-four percent (n = 37) were recommended hearing aids and the majority of these (n = 27) obtained new hearing aids. Seven participants had existing aids adjusted, and 3 obtained alternate assistive listening devices. Almost half of those receiving new aids or adjustments to hearing aids reported low use (day) at follow-up. Among help-seekers, 40% were unsure or did not believe their audiologist knew of their visual diagnosis. Of concern, 60% of participants did not seek help largely due to perceptions their hearing loss was not bad enough; the presence of competing priorities; concerns over dealing with vision loss and managing hearing aids with poor vision. Hearing- and vision-rehabilitation services need
Black, Lindsey I.; Vahratian, Anjel; Hoffman, Howard J.
Increasing the proportion of children with voice, swallowing, speech, or language disorders who receive intervention services is a Healthy People 2020 goal (1). Timely receipt of intervention services is shown to be effective for treatment of communication disorders (2-5). Using data from the 2012 National Health Interview Survey (NHIS), this…
Chinman, Matthew; Hannah, Gordon; McCarthy, Sharon
Homeless veterans are a vulnerable population, with high mortality and morbidity rates. Evidence-based practices for homelessness have been challenging to implement. This study engaged staff members from three VA homeless programs to improve their quality using Getting-To-Outcomes (GTO), a model and intervention of trainings and technical assistance that builds practitioner capacity to plan, implement, and self-evaluate evidence-based practices. Primarily used in community-based, non-VA settings, this study piloted GTO in VA by creating a GTO project within each homeless program and one across all three. The feasibility and acceptability of GTO in VA is examined using the results of the projects, time spent on GTO, and data from focus groups and interviews. With staff members averaging 33 minutes per week on GTO, each team made significant programmatic changes. Homeless staff stated GTO was helpful, and that high levels of communication, staff member commitment to the program, and technical assistance were critical.
Sharla N. Fasko
Full Text Available Recently there has been an ongoing, at times acrimonious, discussion about the newest incarnation of the federal law that mandates special services for children with disabilities. At the heart of the controversy is a relatively new evaluation model referred to as Response to Intervention (RTI. Advocates and stakeholders have been very vocal in their opinions, leaving those down on the frontlines puzzled and confused. Teachers in particular are feeling frustration over yet another, seemingly arbitrary change in the red tape of special education, about which no one has consulted them or even really bothered to explain.Historically, teachers have felt, not unreasonably, a bit victimized by special education law. In 1975, they were told to step aside, that they were not skilled enough to teach children with special needs. Teachers were given a clear message that their role was to keep alert for disabled children and send them on to the experts. Over time, that message has transformed into something quite different; now they hear that they are evading their responsibility by pushing children onto the special education rolls. In addition, procedures for referrals have modified almost yearly; just when they understand the process, it changes.The purpose of this paper is to examine the circumstances that led up to the conception of RTI, and why many people believe it is a significant but necessary change to special education law. In order to understand the rationale behind RTI, it must be examined in the context of the federal laws which necessitated its creation, beginning with Public Law 94-142 (also known as the Education for Handicapped Act, or EHA, passed in 1975, and its subsequent reauthorizations, the most recent of which is the Individuals with Disabilities Education Improvement Act of 2004, or IDEIA. For purposes of brevity in this paper, the original act and its descendants will be collectively referred to as IDEIA, unless an issue specific
Gudzbeler, Grzegorz; Struniawski, Jarosław
Virtual system to improve shooting training and intervention tactics of services responsible for security is a teaching tool that responds to the training needs of taking interventional activities. The system will enable activation of scenarios with a set of variants that are high quality videos. A module within the system will measure psychophysical parameters to provide better training outcomes. Development of a simulator will be achieved due to the latest advances in the field of technology and IT. Its modular design, both in terms of structure and software, will allow it to be easily upgraded and developed in the future.
Mills, Katherine L; Ewer, Philippa; Dore, Glenys; Teesson, Maree; Baker, Amanda; Kay-Lambkin, Frances; Sannibale, Claudia
Trauma exposure and post traumatic stress disorder (PTSD) are common among clients of substance use services. Existing treatments for these co-occurring conditions tend to be lengthy, treatment retention is relatively poor, and they require extensive training and clinical supervision. The aim of the present study was to conduct a preliminary examination of the feasibility and acceptability of a brief intervention for PTSD symptoms among individuals seeking substance use treatment. An uncontrolled open-label pilot study was conducted among 29 inpatients of a medicated detoxification unit in Sydney, Australia. All participants completed a baseline interview followed by the brief intervention. The intervention consists of a single, one-hour manualised session providing psychoeducation pertaining to common trauma reactions and symptom management. PTSD and substance use outcomes were assessed at 1-week, 1-month and 3-month post-intervention. PTSD symptom severity (assessed using the Clinicians Administered PTSD Scale) decreased significantly from baseline to 1-week follow up (β -10.87, 95%CI: -19.75 to -1.99) and again between the 1-week and 3-month follow-ups (β -15.38, 95%CI: -23.20 to -7.57). Despite these reductions, the majority of participants continued to meet criteria for a diagnosis of PTSD and there was no change in participants' negative post-traumatic cognitions. Participants expressed high levels of satisfaction with the intervention. Brief psychoeducation for traumatised clients attending substance use services appears to be feasible, acceptable, and may be of some benefit in reducing PTSD symptoms. However, participants continued to experience symptoms at severe levels; thus, brief intervention may best be conceptualised as a "stepping stone" to further trauma treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.
As part of the planned upgrade of the computer centre infrastructure to meet the LHC computing needs, approximately 150 servers, hosting in particular the NICE home directories, Mail services and Web services, will need to be physically relocated to another part of the computing hall during the weekend of the 21 and 22 August. On Saturday 21 August, starting from 8:30a.m. interruptions of typically 60 minutes will take place on the following central computing services: NICE and the whole Windows infrastructure, Mail services, file services (including home directories and DFS workspaces), Web services, VPN access, Windows Terminal Services. During any interruption, incoming mail from outside CERN will be queued and delivered as soon as the service is operational again. All Services should be available again on Saturday 21 at 17:30 but a few additional interruptions will be possible after that time and on Sunday 22 August. IT Department
Full Text Available Abstract Background There is evidence that exposure to passive smoking in general, and in babies in particular, is an important cause of morbimortality. Passive smoking is related to an increased risk of pediatric diseases such as sudden death syndrome, acute respiratory diseases, worsening of asthma, acute-chronic middle ear disease and slowing of lung growth. The objective of this article is to describe the BIBE study protocol. The BIBE study aims to determine the effectiveness of a brief intervention within the context of Primary Care, directed to mothers and fathers that smoke, in order to reduce the exposure of babies to passive smoking (ETS. Methods/Design Cluster randomized field trial (control and intervention group, multicentric and open. Subject: Fathers and/or mothers who are smokers and their babies (under 18 months that attend pediatric services in Primary Care in Catalonia. The measurements will be taken at three points in time, in each of the fathers and/or mothers who respond to a questionnaire regarding their baby's clinical background and characteristics of the baby's exposure, together with variables related to the parents' tobacco consumption. A hair sample of the baby will be taken at the beginning of the study and at six months after the initial visit (biological determination of nicotine. The intervention group will apply a brief intervention in passive smoking after specific training and the control group will apply the habitual care. Discussion Exposure to ETS is an avoidable factor related to infant morbimortality. Interventions to reduce exposure to ETS in babies are potentially beneficial for their health. The BIBE study evaluates an intervention to reduce exposure to ETS that takes advantage of pediatric visits. Interventions in the form of advice, conducted by pediatric professionals, are an excellent opportunity for prevention and protection of infants against the harmful effects of ETS. Trial Registration Clinical
Wu, Hairong; Chen, Jiao; Zou, Lianbin; Zheng, Liefeng; Zhang, Weichao; Meng, Zhenmu; Magalhaes, Ricardo J Soares; Wang, Youming; Kang, Jingli; Sun, Xiangdong
In China canine rabies poses a serious public health problem in that human mortality ranks the second highest globally. While rabies health education interventions are advocated by WHO to be critical components of modern rabies control and prevention programs, available studies have not adequately investigated the relative efficacy of their implementation in at-risk populations. This study aims to measure and compare the effect on knowledge and protective behavior towards rabies of health education interventions that include a novel Short Messaging Service via cell phone (SMS) and rabies health information sessions (IS). The study used a between-subject design involving repeated measures of rabies-related KAP (knowledge, attitude and practice). A total of 350 randomly selected villagers were randomly allocated into three intervention (SMS, IS and SMS + IS) and one control group. The content of SMS and IS covered topics about rabies prevention and route of transmission. The SMS intervention consisted of ten separate messages delivered three times two weeks after the pretest; the IS intervention was conducted once immediately after the pretest. A validated questionnaire was used to capture demographic information and KAP information. Ordinary Least Squares regression was used to contrast the effects of interventions. Our results indicate that overall SMS outperforms IS at improving knowledge and protective behavior against rabies. Our results suggest that a combined intervention of SMS and IS can result in higher scores than any of the two in isolation. The impact of SMS, IS and SMS + IS is greatest on knowledge, followed by attitude and practice scores. This study demonstrated that health communication modes based on SMS, IS and a combination of the two are all effective to improve rabies-related KAP in the short term. These findings highlight the potential usefulness of SMS as an additional tool for public health communication and promotion; further studies
VanDeMark Nancy R
Full Text Available Abstract Background The continuing gap between the number of people requiring treatment for substance use disorders and those receiving treatment suggests the need to develop new approaches to service delivery. Meanwhile, the use of technology to provide counseling and support in the substance abuse field is exploding. Despite the increase in the use of technology in treatment, little is known about the impact of technology-supported interventions on access to services for substance use disorders. The E-TREAT intervention brings together the evidence-based practice of Motivational Interviewing and theories of Persuasive Technology to sustain clients' motivation to change substance use behaviors, provide support for change, and facilitate continuity across treatment settings. Methods This study used descriptive statistics, tests of statistical significance, and logistic regression to explore the characteristics and perceptions of the first 157 people who agreed to participate in E-TREAT and the predictors of their active engagement in E-TREAT services. In addition, responses to open-ended questions about the participants' experiences with the intervention were analyzed. Results The data reveal that clients who engaged in E-TREAT were more likely than those who did not engage to be female, have children and report a positive relationship with their recovery coach, and were less likely to have completed treatment for a substance use disorder in the past. A majority of people engaging in E-TREAT reported that it was helpful to talk with others with similar problems and that the program assisted them in developing a sense of community. Conclusions The authors conclude that technology-assisted interventions hold promise in expanding access to treatment for substance use disorders especially for women and parents. Further, the characteristics of the relationship with a coach or helper may be critical to engagement in technology-supported interventions
Full Text Available Purpose: E-Government, as a new bond linking the government and the public, has gradually become the focus of innovation in government services. The paper focuses on the e-Government service quality issues from the perspective of users. Design/methodology/approach: From the aspects of online service quality perception and offline service quality perception, based on IS Success model and SERQUAL model, e-Government Services Quality model has been set up with information quality, system quality and service quality as key factors. Then, the survey method was applied to collect data and then to test the model. Findings: It was found that users’ perception of offline service quality has a significant effect on improving their perception of online service quality, and online service quality perception has a significant effect on public satisfaction of e-Government services; information clarity, system security and stability, interactive services and “one-stop” services all have a significant effect on public satisfaction of e-Government services. However, offline service quality perception has certain positive effect on public satisfaction of e-Government services but not dramatically. Research limitations/implications: Mobile e-Government as an important direction of the development of e-Government, in the future, we will study more about mobile e-Government services channels. Originality/value: This study further develops the theory of information system service quality, and also provides a theoretical reference for government departments. On the one hand, based on the characteristics of e-government system, information quality, system quality and service quality in the previous system service model are further discussed; on the other hand, both online and offline services are taken into consideration in the information system service model, thus establishing the e-government services quality model and making an in-depth study of the
Roumen, C.; Feskens, E.J.M.; Corpeleijn, E.; Mensink, M.R.; Saris, W.H.M.; Blaak, E.E.
Original Article European Journal of Clinical Nutrition (2011) 65, 1141–1147; doi:10.1038/ejcn.2011.74; published online 18 May 2011 Predictors of lifestyle intervention outcome and dropout: the SLIM study C Roumen1, E J M Feskens2, E Corpeleijn1, M Mensink2, W H M Saris1 and E E Blaak1 1Department
Roumen, C; Feskens, E J M; Corpeleijn, E; Mensink, M; Saris, W H M; Blaak, E E
BACKGROUND/OBJECTIVES: To evaluate the effect of a 4.1-year (range 3-6 years) lifestyle intervention according to general public health recommendations on glucose tolerance and dropout in a Dutch population with impaired glucose tolerance (IGT). SUBJECTS/METHODS: In the Study on Lifestyle
McMahon, Chris G
Large well-designed clinical efficacy and safety randomized clinical trials (RCTs) are required to achieve regulatory approval of new drug treatments. The objective of this article is to make recommendations for the criteria for defining and selecting the clinical trial study population, design and efficacy outcomes measures which comprise ideal premature ejaculation (PE) interventional trial methodology. Data on clinical trial design, epidemiology, definitions, dimensions and psychological impact of PE was reviewed, critiqued and incorporated into a series of recommendations for standardisation of PE clinical trial design, outcome measures and reporting using the principles of evidence based medicine. Data from PE interventional studies are only reliable, interpretable and capable of being generalised to patients with PE, when study populations are defined by the International Society for Sexual Medicine (ISSM) multivariate definition of PE. PE intervention trials should employ a double-blind RCT methodology and include placebo control, active standard drug control, and/or dose comparison trials. Ejaculatory latency time (ELT) and subject/partner outcome measures of control, personal/partner/relationship distress and other study-specific outcome measures should be used as outcome measures. There is currently no published literature which identifies a clinically significant threshold response to intervention. The ISSM definition of PE reflects the contemporary understanding of PE and represents the state-of-the-art multi-dimensional definition of PE and is recommended as the basis of diagnosis of PE for all PE clinical trials.
Dragsted, L. O.; Kristensen, M.; Ravn-Haren, Gitte
Metabolomics is a promising tool for searching out new biomarkers and the development of hypotheses in nutrition research. This chapter will describe the design of human dietary intervention studies where samples are collected for metabolomics analyses as well as the analytical issues and data...
Häfner, Alexander; Stock, Armin; Oberst, Verena
The aim of this study was to examine the effects of a time management training program on perceived control of time and perceived stress in the context of higher education. Twenty-three undergraduate students attended a time management training intervention and reported demands, perceived stress and perceived control of time directly before 2 and…
Hasson, Natalie; Dodd, Barbara
Dynamic assessments (DA) of language have been shown to be a useful addition to the battery of tests used to diagnose language impairments in children, and to evaluate their skills. The current article explores the value of the information gained from a DA in planning intervention for a child with language impairment. A single case study was used…
Häfner, Alexander; Oberst, Verena; Stock, Armin
The purpose of this study was to examine the effects of a short-term time management intervention on procrastination. Procrastination is a serious issue for many students and associated with different negative consequences, such as anxiety or low grades. As procrastination is described as a self-regulatory failure, a training programme focussing…
Poulsen, Signe; Ipsen, Christine; Gish, Liv
There is a need for an increased understanding of organizational readiness in relation to interventions. The study examines the implementation of the PoWRS model in four case companies. During the implementation period that companies have been interviewed, answered surveys and employees...
MacMillan, Freya; Karamacoska, Diana; El Masri, Aymen; McBride, Kate A; Steiner, Genevieve Z; Cook, Amelia; Kolt, Gregory S; Klupp, Nerida; George, Emma S
To systematically review studies of health promotion intervention in the police force. Four databases were searched for articles reporting on prepost single and multigroup studies in police officers and trainees. Data were extracted and bias assessed to evaluate study characteristics, intervention design and the impact of interventions on health. Database searching identified 25 articles reporting on 21 studies relevant to the aims of this review. Few studies (n=3) were of long duration (≥6 months). Nine of 21 studies evaluated structured physical activity and/or diet programmes only, 5 studies used education and behaviour change support-only interventions, 5 combined structured programmes with education and behaviour change support, and 2 studies used computer prompts to minimise sedentary behaviour. A wide array of lifestyle behaviour and health outcomes was measured, with 11/13 multigroup and 8/8 single-group studies reporting beneficial impacts on outcomes. High risk of bias was evident across most studies. In those with the lowest risk of bias (n=2), a large effect on blood pressure and small effects on diet, sleep quality, stress and tobacco use, were reported. Health promotion interventions can impact beneficially on health of the police force, particularly blood pressure, diet, sleep, stress and tobacco use. Limited reporting made comparison of findings challenging. Combined structured programmes with education and behaviour change support and programmes including peer support resulted in the most impact on health-related outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Considine, Julie; Lucas, Elspeth; Martin, Roslyn; Stergiou, Helen E; Kropman, Matthew; Chiu, Herman
The impact of emergency nursing roles in demand management systems is poorly understood. The aim of this study was to evaluate emergency nurses' role in a specific emergency department (ED) demand management system: rapid intervention and treatment zone (RITZ). A descriptive exploratory approach was used. Data were collected from audit of 193 randomly selected patient records and 12 h of clinical practice observation. The median age of participants was 31 years, 51.8% were males and 99.5% were discharged home. Nurse qualifications or seniority had no significant effect on waiting time or length of stay (LOS). There were disparities between documented and observed nursing practice. The designation and qualifications of RITZ nurses made little difference to waiting times and ED LOS. Specific documentation and communication systems for areas of the ED that manage large numbers of low complexity patients warrant further research. © 2012 Blackwell Publishing Asia Pty Ltd.
Although models of service quality and customer satisfaction have been well researched within the consumer goods and services area, much less attention has been paid to high involvement business-to-business service satisfaction. The objective of this study is to contribute to this stream...
Chung, Mei; Raman, Gowri; Trikalinos, Thomas; Lau, Joseph; Ip, Stanley
Evidence suggests that breastfeeding decreases the risk for many diseases in mothers and infants. It is therefore important to evaluate the effectiveness of breastfeeding interventions. To systematically review evidence for the effectiveness of primary care-initiated interventions to promote breastfeeding with respect to breastfeeding and child and maternal health outcomes. Electronic searches of MEDLINE, the Cochrane Central Register of Controlled Trials, and CINAHL from September 2001 to February 2008 and references of selected articles, restricted to English-language publications. Randomized, controlled trials of primary care-initiated interventions to promote breastfeeding, mainly in developed countries. Characteristics of interventions and comparators, study setting, study design, population characteristics, the proportion of infants continuing breastfeeding by different durations, and infant or maternal health outcomes were recorded. Thirty-eight randomized, controlled trials (36 in developed countries) met eligibility criteria. In random-effects meta-analyses, breastfeeding promotion interventions in developed countries resulted in significantly increased rates of short- (1 to 3 months) and long-term (6 to 8 months) exclusive breastfeeding (rate ratios, 1.28 [95% CI, 1.11 to 1.48] and 1.44 [CI, 1.13 to 1.84], respectively). In subgroup analyses, combining pre- and postnatal breastfeeding interventions had a larger effect on increasing breastfeeding durations than either pre- or postnatal interventions alone. Furthermore, breastfeeding interventions with a component of lay support (such as peer support or peer counseling) were more effective than usual care in increasing the short-term breastfeeding rate. Meta-analyses were limited by clinical and methodological heterogeneity. Reliable estimates for the isolated effects of each component of multicomponent interventions could not be obtained. Evidence suggests that breastfeeding interventions are more
Champion, Jane Dimmitt; Collins, Jennifer L
To report a retrospective analysis of data routinely collected in the course of healthcare services at a rural health clinic and to assess obesity incidence and associated interventions among rural Mexican-American adolescents. Two hundred and twelve charts reviewed; 98 (46.2%) males and 114 (53.8%) females. Data extracted included Medicaid exams conducted at the clinic within 5 years. Equal overweight or obese (n = 105, 49.5%), versus normal BMI categorizations (n = 107, 50.5%) documented overall and by gender. Female obesity higher (25.4%) than national norms (17.4%); male rates (25.5%) were within national norm. Interventions provided by nurse practitioners (94%) for 34.8%-80% of overweight/obese had limited follow-up (4%). Obesity incidence markedly increased between 13 and 18 years of age without associated interventions; 51.4%-75.6% without interventions. Obesity is a healthcare problem among rural Mexican-American adolescents accessing care at the rural health clinic. Obesity intervention and follow-up was suboptimal within this setting. Rural and ethnic minority adolescents experience health disparities concerning obesity prevalence and remote healthcare access. Obesity prevention and treatment during adolescence is a national health priority given physiologic and psychological tolls on health and potential for obesity into adulthood. Obesity assessment and translation of evidence-based interventions for rural Mexican-American adolescents at rural health clinics is implicated. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.
Kingkaew, Pritaporn; Glidewell, Liz; Walwyn, Rebecca; Fraser, Hamish; Wyatt, Jeremy C
Mobile health (mHealth) interventions for smoking cessation have been shown to be associated with an increase in effectiveness. However, interventions using mobile phones to change people's behaviour are often perceived as complex interventions, and the interactions between several components within them may affect the outcome. Therefore, it is important to understand how we can improve the design of mHealth interventions using mobile phones as a medium to deliver services. Randomised controlled trials (RCTs) of mHealth interventions to support smoking cessation or uptake of smoking cessation services for smokers will be included in this systematic review. A search will be performed by searching MEDLINE, MEDLINE(R) In-Process & Other Non-Indexed Citations, EMBASE, PsycINFO, Web of Science, and CINAHL. A search for new publications will be conducted 3 months prior to submission for publication as mHealth is an emerging area of research. A random-effects meta-analysis model will be used to summarise the effectiveness of mHealth interventions. The risk ratio will be used for the primary outcome, self-reported or verified smoking abstinence, and any binary outcomes for uptake of smoking cessation services. The standardised mean difference using Hedges' g will be reported for continuous data. Heterogeneity will be assessed using I (2) statistics. Where feasible, meta-regression analysis using random-effects multilevel modelling will be conducted to examine the association of pre-specified characteristics (covariates) at the study level with the effectiveness of interventions. Publication bias will be explored using Egger's test for continuous outcomes and Harbord and Peters tests for dichotomous outcomes. The funnel plot will be used to evaluate the presence of publication bias. The Cochrane Risk of Bias Tool will be used to assess differences in risks of bias. The results of this systematic review will provide future research with a foundation for designing and
Full Text Available Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group (with participants allocated to group by geographical location. Significant improvements were found in the drumming group but not the control group: by week 6 there were decreases in depression (-2.14 SE 0.50 CI -3.16 to -1.11 and increases in social resilience (7.69 SE 2.00 CI 3.60 to 11.78, and by week 10 these had further improved (depression: -3.41 SE 0.62 CI -4.68 to -2.15; social resilience: 10.59 SE 1.78 CI 6.94 to 14.24 alongside significant improvements in anxiety (-2.21 SE 0.50 CI -3.24 to -1.19 and mental wellbeing (6.14 SE 0.92 CI 4.25 to 8.04. All significant changes were maintained at 3 months follow-up. Furthermore, it is now recognised that many mental health conditions are characterised by underlying inflammatory immune responses. Consequently, participants in the drumming group also provided saliva samples to test for cortisol and the cytokines interleukin (IL 4, IL6, IL17, tumour necrosis factor alpha (TNFα, and monocyte chemoattractant protein (MCP 1. Across the 10 weeks there was a shift away from a pro-inflammatory towards an anti-inflammatory immune profile. Consequently, this study demonstrates the psychological benefits of group drumming and also suggests underlying biological effects, supporting its therapeutic potential for mental health.ClinicalTrials.gov NCT01906892.
Chan, Roxane Raffin; Giardino, Nicholas; Larson, Janet L
Living well with chronic obstructive pulmonary disease (COPD) requires people to manage disease-related symptoms in order to participate in activities of daily living. Mindfulness practice is an intervention that has been shown to reduce symptoms of chronic disease and improve accurate symptom assessment, both of which could result in improved disease management and increased wellness for people with COPD. A randomized controlled trial was conducted to investigate an 8-week mindful meditation intervention program tailored for the COPD population and explore the use of breathing timing parameters as a possible physiological measure of meditation uptake. Results demonstrated that those randomized to the mindful meditation intervention group (N=19) had a significant increase in respiratory rate over time as compared to those randomized to the wait-list group (N=22) (P=0.045). It was also found that the mindful meditation intervention group demonstrated a significant decrease in level of mindfulness over time as compared to the wait-list group (P=0.023). When examining participants from the mindful meditation intervention who had completed six or more classes, it was found that respiratory rate did not significantly increase in comparison to the wait-list group. Furthermore, those who completed six or more classes (N=12) demonstrated significant improvement in emotional function in comparison to the wait-list group (P=0.032) even though their level of mindfulness did not improve. This study identifies that there may be a complex relationship between breathing parameters, emotion, and mindfulness in the COPD population. The results describe good feasibility and acceptability for meditation interventions in the COPD population.
Full Text Available BACKGROUND: In Brazil, tungiasis is endemic in some resource-poor communities where various domestic and sylvatic animals act as reservoirs for this zoonosis. To determine the effect of control measures on the prevalence and intensity of infestation of human and animal tungiasis, a repeated cross-sectional survey with intervention was carried out. METHODOLOGY/PRINCIPAL FINDINGS: In a traditional fishing community in Northeast Brazil, humans and reservoir animals were treated, and premise-spraying using an insecticide was done, while a second fishing community served as a control. Both communities were followed up 10 times during a 12-month period. At baseline, prevalence of tungiasis was 43% (95% confidence interval [CI]: 35%-51% and 37% (95% CI: 31%-43% in control and intervention villages, respectively. During the study, prevalence of tungiasis dropped to 10% (95% CI: 8%-13%; p<0.001 in the intervention village, while the prevalence remained at a high level in the control village. However, after one year, at the end of the study, in both communities the prevalence of the infestation had reached pre-intervention levels. Whereas the intensity of infestation was significantly reduced in the intervention community (p<0.001, and remained low at the end of the study (p<0.001, it did not change in the control village. CONCLUSION/SIGNIFICANCE: Our study shows that a reduction of prevalence and intensity of infestation is possible, but in impoverished communities a long-lasting reduction of disease occurrence can only be achieved by the regular treatment of infested humans, the elimination of animal reservoirs, and, likely, through environmental changes. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN27670575.
Jacobs, Bart; Ir, Por; Bigdeli, Maryam; Annear, Peter Leslie; Van Damme, Wim
While World Health Organization member countries embraced the concept of universal coverage as early as 2005, few low-income countries have yet achieved the objective. This is mainly due to numerous barriers that hamper access to needed health services. In this paper we provide an overview of the various dimensions of barriers to access to health care in low-income countries (geographical access, availability, affordability and acceptability) and outline existing interventions designed to ove...
Wickins-Drazilova, D; Williams, G
The methodology of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study raises a number of important ethical questions. Many of these are already well recognised in ethical guidelines that uphold principles of individual and parental consent, confidentiality and scientific review. There are, however, wider issues that require ethical reflection. In this paper, we focus on a set of problems surrounding the evaluation of complex social interventions, and argue that comprehensive and objective evaluation is a much more ethically charged aim than it may first appear. In particular, we contend that standard scientific measures-of body size and biomarkers-convey only part of the story. This is partly because, when we intervene in communities, we are also concerned with complex social effects. These effects are made even more complex by contemporary social anxieties about fat and physical appearance, as well as about the safety and security of children. Such anxieties increase the risk of undesirable side effects that are themselves difficult to gauge. In the face of these and other complexities, we argue that the evaluation of interventions should involve a strong ethical dimension. First, it must include-as does the IDEFICS study-consideration of the opinions of the people affected, who are subjected to interventions in ways that necessarily go beyond individual consent. Second, we suggest that interventions might also be assessed by how much they empower people-and especially those persons, such as children, who are otherwise often disempowered.
Lopez, Nanette V; Folta, Sara C; Glenn, Meaghan E; Lynskey, Vanessa M; Patel, Anjali A; Anzman-Frasca, Stephanie
High-calorie restaurant foods contribute to childhood overweight. Increased consumer demand for healthier kids' meals may motivate the restaurant industry to provide additional healthy options. This study pilot-tested a combination of four strategies (toy incentive, placemats, server prompts, signage) designed to increase demand for healthier kids' meals, which were defined as those eligible for the National Restaurant Association's Kids LiveWell program. Relative sales of healthier kids' meals were examined before (n = 3473 total kids' meal orders) and during Month 1 (n = 3546 total kids' meal orders) and Month 2 of implementation (n = 3645 total kids' meal orders) of an 8-week intervention in two locations each of a quick-service (QSR) and full-service (FSR) restaurant chain. Convenience samples of children (n = 27) and their parents (n = 28) were surveyed regarding parent and child perceptions of intervention components. Findings regarding the effectiveness and feasibility of the intervention were mixed. At the FSRs, the relative percentage of monthly sales from healthier kids' meals increased from 5.0% of kids' meal orders at baseline to 8.3% during Month 1, ending at 6.4% during Month 2. At the QSRs, the relative percentage of monthly sales from healthier kids' entrees decreased from 27.5% at baseline to 25.2% during Month 1, ending at 25.9% during Month 2. Implementation quality tracking showed that consistent implementation of intervention components was a challenge; parent- and child-reported awareness of intervention components supported this finding. Future directions are discussed, aiming to build upon these findings and maximize the feasibility, effectiveness, and sustainability of efforts to promote healthier eating in restaurants. Copyright © 2017 Elsevier Ltd. All rights reserved.
Armstrong, Daniel P; Ferron, Richard; Taylor, Cindi; McLeod, Brent; Fletcher, Steve; MacPhee, Renée S; Fischer, Steven L
Paramedic services are considering moving towards the use of powered stretcher and load systems to reduce stretcher related injuries, but cost is perceived as a barrier. This study compared injury incidence rates, days lost, and compensation costs between Niagara Emergency Medical Service (NEMS) and Hamilton Paramedic Service (HPS) pre- (four years) and post- (one year) implementation of powered stretcher and load systems in NEMS. Prior to the intervention stretcher related musculoskeletal disorder (MSD) incidence rates averaged 20.0 (±6.8) and 17.9 (±6.4) per 100 full time equivalent (FTE), in NEMS and HPS respectively. One-year post intervention rates decreased to 4.3 per 100 FTE in NEMS, a 78% reduction. Rates modestly increased to 24.6 per 100 FTE in HPS in same period. Cost-benefit analysis estimated that the added cost to purchase powered stretcher and load systems would be recovered within their expected 7-year service life due to the reduction in compensation costs. Copyright © 2017 Elsevier Ltd. All rights reserved.
Cheung, Kei-Long; Wijnen, Ben F M; Hiligsmann, Mickaël; Coyle, Kathryn; Coyle, Doug; Pokhrel, Subhash; de Vries, Hein; Präger, Maximilian; Evers, Silvia M A A
The cost-effectiveness of internet-based smoking cessation interventions is difficult to determine when they are provided as a complement to current smoking cessation services. The aim of this study was to evaluate the cost-effectiveness of such an alternate package compared with existing smoking cessation services alone (current package). A literature search was conducted to identify internet-based smoking cessation interventions in the Netherlands. A meta-analysis was then performed to determine the pooled effectiveness of a (web-based) computer-tailored intervention. The mean cost of implementing internet based interventions was calculated using available information, while intervention reach was sourced from an English study. We used EQUIPTMOD, a Markov-based state-transition model, to calculate the incremental cost-effectiveness ratios [expressed as cost per quality-adjusted life years (QALYs) gained] for different time horizons to assess the value of providing internet-based interventions to complement the current package.). Deterministic sensitivity analyses tested the uncertainty around intervention costs per smoker, relative risks, and the intervention reach. Internet-based interventions had an estimated pooled relative risk of 1.40; average costs per smoker of €2.71; and a reach of 0.41% of all smokers. The alternate package (i.e. provision of internet-based intervention to the current package) was dominant (cost-saving) compared with the current package alone (0.14 QALY gained per 1000 smokers; reduced health-care costs of €602.91 per 1000 smokers for the life-time horizon). The alternate package remained dominant in all sensitivity analyses. Providing internet-based smoking cessation interventions to complement the current provision of smoking cessation services could be a cost-saving policy option in the Netherlands. © 2017 Society for the Study of Addiction.
Minh, Pham Duc; Huong, Dinh Thi Mai; Byrkit, Ramona; Murray, Marjorie
To assess the effectiveness of a training and supportive supervision intervention in strengthening the capacity of pharmacy staff in Vietnam to deliver client-oriented, accurate healthcare information and appropriate services for childhood diarrhoea and emergency contraceptive pills (ECP). Pre- and post-intervention study using a cross-sectional design. Pharmacy staff participated in 3 days of training on customer relations, good pharmacy practice, childhood diarrhoea and ECP over a period of 1 month, consisting of lectures, discussion, question-and-answer sessions and role-playing. We compared baseline and 6-month post-intervention surveys to ascertain changes in knowledge, attitudes and practice of pharmacists, using univariate statistics to find significant differences. More than 1200 pharmacists received training and supportive supervision. After interventions, pharmacy staff knowledge was significantly improved on most of the measured indicators. Knowledge of dehydration symptoms for diarrhoea increased from 19% to 88%, and for side effects of ECP increased from 27% to 77%. While assessment of actual practice revealed that this knowledge was not always used, significant improvement was observed. Before interventions, 12% gave information on dehydration symptoms but 45% did so afterwards. The proportion giving information on side effects of ECP increased from 13% to 54%. Providing a programme of training and supportive supervision is an effective way to improve knowledge and practice of pharmacists at private pharmacies in Vietnam. These improvements have the potential to lead to better community health care. © 2013 Blackwell Publishing Ltd.
von Thiele Schwarz, Ulrica; Nielsen, Karina M; Stenfors-Hayes, Terese; Hasson, Henna
Participatory intervention approaches that are embedded in existing organizational structures may improve the efficiency and effectiveness of organizational interventions, but concrete tools are lacking. In the present article, we use a realist evaluation approach to explore the role of kaizen, a lean tool for participatory continuous improvement, in improving employee well-being in two cluster-randomized, controlled participatory intervention studies. Case 1 is from the Danish Postal Service, where kaizen boards were used to implement action plans. The results of multi-group structural equation modeling showed that kaizen served as a mechanism that increased the level of awareness of and capacity to manage psychosocial issues, which, in turn, predicted increased job satisfaction and mental health. Case 2 is from a regional hospital in Sweden that integrated occupational health processes with a pre-existing kaizen system. Multi-group structural equation modeling revealed that, in the intervention group, kaizen work predicted better integration of organizational and employee objectives after 12 months, which, in turn, predicted increased job satisfaction and decreased discomfort at 24 months. The findings suggest that participatory and structured problem-solving approaches that are familiar and visual to employees can facilitate organizational interventions.
Calderon, Juan; Collins, Thomas W; Devinney, Edward; Driggers, Gene J; Dunmyer, Valrica; Flood, Paul; Gallant, Robin; Kekauoha, Stanford K; Krawietz, Anthony B; Kumashiro, Patrick T; LaDue, Paul W; LaFalce, John; Larson, Steven W; Lawrence, Steven J; Nettleton, John; Ostrowski, John A
The extensive media coverage of the 2008 subprime crisis, both domestically and abroad, drives home the crucial role that the financial services industry plays for not only individual Americans, but for U.S. national security...
Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...
Foster Charlie E
Full Text Available Abstract Purpose Most researchers who are conducting physical activity trials face difficulties in recruiting participants who are representative of the population or from specific population groups. Participants who are often the hardest to recruit are often those who stand to benefit most (the least active, from ethnic and other minority groups, from neighbourhoods with high levels of deprivation, or have poor health. The aim of our study was to conduct a systematic review of published literature of walking interventions, in order to identify the impact, characteristics, and differential effects of recruitment strategies among particular population groups. Methods We conducted standard searches for studies from four sources, (i electronic literature databases and websites, (ii grey literature from internet sources, (iii contact with experts to identify additional "grey" and other literature, and (iv snowballing from reference lists of retrieved articles. Included studies were randomised controlled trials, controlled before-and-after experimental or observational qualitative studies, examining the effects of an intervention to encourage people to walk independently or in a group setting, and detailing methods of recruitment. Results Forty seven studies met the inclusion criteria. The overall quality of the descriptions of recruitment in the studies was poor with little detail reported on who undertook recruitment, or how long was spent planning/preparing and implementing the recruitment phase. Recruitment was conducted at locations that either matched where the intervention was delivered, or where the potential participants were asked to attend for the screening and signing up process. We identified a lack of conceptual clarity about the recruitment process and no standard metric to evaluate the effectiveness of recruitment. Conclusion Recruitment concepts, methods, and reporting in walking intervention trials are poorly developed, adding to
Lowe, Michael R.; Tappe, Karyn A.; Butryn, Meghan L.; Annunziato, Rachel A.; Coletta, Maria C.; Ochner, Christopher N.; Rolls, Barbara J.
Modifying the food environment is a promising strategy for promoting healthier eating behavior. This study aimed to evaluate nutritional and weight changes in a program that used worksite cafeterias to reduce employees’ calorie content of purchased foods and improve their macronutrient intake. Participants were randomly assigned to one of two conditions: 1) only environmental change (i.e., the introduction of 10 new low-energy-density (ED) foods and provision of labels for all foods sold at lunch, which listed ED, calories, and macronutrient content) or 2) the environmental change plus pricing incentives for purchasing low-ED foods and education about low-ED eating delivered in four, 1-hour group sessions. Participant lunch choices were monitored electronically at the point of purchase for 3 months before the intervention was instituted (i.e., the baseline period) and for 3 months afterward (i.e., intervention period). Participants were adults (n = 96, BMI = 29.7 ± 6.0 kg/m2) who regularly ate lunch at their workplace cafeteria. There was no difference between groups in total energy intake over the study period. Across groups, energy and percent of energy from fat decreased and percent of energy from carbohydrate increased from baseline to the intervention period (all p <. 01). Follow-up analyses, conducted by averaging Baseline Months 1 and 2 and comparing them to Intervention Month 3 as a conservative estimate of overall impact of the intervention, indicated that change in energy, carbohydrate, and fat intake remained significant (p < .001). Providing nutrition labels and reducing the ED of selected foods was associated with improved dietary intake. PMID:20434060
Berry, Ruth; Firth, Graham; Leeming, Catherine; Sharma, Vishal
Intensive Interaction was initially developed in the 1980s as an educational approach for developing social communication and engagement with people with severe or profound intellectual disabilities and/or autism. Intensive Interaction has subsequently been adopted by a range of practitioners and professionals working in learning disability services and has a broad multi-disciplinary acceptance, being recommended in a number of UK governmental guidance documents. Despite this, there has been limited work on developing a deeper psychological understanding of the approach. This study utilises a qualitative description/thematic analysis approach to explore how clinical psychologists conceptualise the approach with regard to currently accepted psychological theories, as well as looking at other factors that influence their adoption and advocacy. The sample deliberately consisted of eight NHS (National Health Service) clinical psychologists known to be using or advocating the use of Intensive Interaction with people with a learning disability. The results of this study indicate that although the participants referred to some theories that might explain the beneficial outcomes of Intensive Interaction, these theories were rarely explicitly or clearly referenced, resulting in the authors having to attribute specific theoretical positions on the basis of inductive analysis of the participants' responses. Moreover, the participants provided varying views on how Intensive Interaction might be conceptualised, highlighting the lack of a generally accepted, psychologically framed definition of the approach. In conclusion, it was felt that further research is required to develop a specifically psychological understanding of Intensive Interaction alongside the formation of a Special Interest Group, which might have this task as one of its aims. There appeared to be a limited recognition amongst the participants of the specific psychological theories that can be seen to explain
Simmons, Magenta B; Coates, Dominiek; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deborah
Youth participation is central to early intervention policy and quality frameworks. There is good evidence for peer support (individuals with lived experience helping other consumers) and shared decision making (involving consumers in making decisions about their own care) in adult settings. However, youth programs are rarely tested or described in detail. This report aims to fill this gap by describing a consumer focused intervention in an early intervention service. This paper describes the development process, intervention content and implementation challenges of the Choices about Healthcare Options Informed by Client Experiences and Expectations (CHOICE) Pilot Project. This highly novel and innovative project combined both youth peer work and youth shared decision making. Eight peer workers were employed to deliver an online shared decision-making tool at a youth mental health service in New South Wales, Australia. The intervention development involved best practice principles, including international standards and elements of co-design. The implementation of the peer workforce in the service involved a number of targeted strategies designed to support this new service model. However, several implementation challenges were experienced which resulted in critical learning about how best to deliver these types of interventions. Delivering peer work and shared decision making within an early intervention service is feasible, but not without challenges. Providing adequate detail about interventions and implementation strategies fills a critical gap in the literature. Understanding optimal youth involvement strategies assists others to deliver acceptable and effective services to young people who experience mental ill health. © 2017 John Wiley & Sons Australia, Ltd.
Diaby, A; Gilboy, A C
To better demonstrate the importance and usefulness of a scientific managerial approach in public health-care institutions to "team building" and institutional performance, this study aimed to evaluate the impact of interventions for organizational development of the Division of Reproductive Health (DRH) in Senegal. This cross-sectional assessment study, conducted in April-May 2014, focused on a sample of 25 DRH staff members and 4 key informants among partners/consultants after a review of the documentation relating to the process from design to implementation. Self-administered questionnaires and interviews provided the data. All respondents, including 19 women and 6 men, came from DRH offices. Staff unanimously noted the benefits of organizational development process, including improved understanding of DRH's vision, mission, and objectives, clarification of the roles and responsibilities of all staff members, improvement of the work environment, and the development of collective awareness, etc. Staff members noted the encouraging results. Nonetheless, the definitive establishment of an organizational culture remains to be shown.
Donovan, Leigh A; Wakefield, Claire E; Russell, Vera; Cohn, Richard J
There has been a breadth of research on the grief experience of parents following the death of a child. However, the role and impact of hospital-based bereaved services remain unclear. To identify services offered to bereaved families in perinatal, neonatal, and pediatric hospital settings and summarize the psychosocial impact of these services and published recommendations for best practice hospital-based bereavement care. Systematic review of qualitative, quantitative, and mixed method studies guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and methodological quality appraised in accordance with the Mixed Method Appraisal Tool. MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health, and PsychINFO were searched to find studies describing hospital-based bereavement services/interventions for parents, siblings, and grandparents. In all, 14 qualitative, 6 quantitative, and 10 mixed method studies were identified. Nine descriptive articles were also included. Qualitatively, family members described feeling cared for and supported by staff, a reduction in sense of isolation, and improved coping and personal growth. Quantitatively, bereavement services have most effect for parents experiencing more complex mourning. It is recommended that bereavement services be theoretically driven and evidence based, offer continuity of care prior to and following the death of a child, and provide a range of interventions for the "whole family" and flexibility in service delivery. There is a role for transitional hospital-based services/interventions for families in the lead up to and following the death of a child. Further mixed method research is required to inform best practice bereavement care guidelines in the perinatal, neonatal, and pediatric hospital settings. © The Author(s) 2014.
Boscarino, Joseph A.; Adams, Richard E.; Figley, Charles R.
Postdisaster crisis interventions have been viewed by many as the appropriate and immediate approach to enhance psychological well-being among persons affected by large-scale traumatic events. Yet, studies and systematic reviews have challenged the effectiveness of these efforts. This article provides the first rigorous scientific evidence to suggest that postdisaster crisis interventions in the workplace significantly reduced mental health disorders and symptoms up to 2 years after the initial interventions. Until now, studies have neither focused on the effectiveness and safety of brief mental health services following disasters, or traumatic events generally, nor examined the long-term impact of these interventions across a spectrum of outcomes using a rigorous research design. The focus of this study was to examine the impact of brief mental health crisis interventions received at the worksite following the World Trade Center disaster (WTCD) among a random sample of New York adults. The data for the present study come from a prospective cohort study of 1,681 adults interviewed by telephone at 1 year and 2 years after this event. Results indicate that worksite crisis interventions offered by employers following the WTCD had a beneficial impact across a spectrum of outcomes, including reduced risks for binge drinking, alcohol dependence, PTSD symptoms, major depression, somatization, anxiety, and global impairment, compared with individuals who did not receive these interventions. In addition, it appeared that 2−3 brief sessions achieved the maximum benefit for most outcomes examined. Implications for postdisaster crisis interventions efforts are discussed. PMID:15869077
Full Text Available The purpose of this study is to improve library promotional marketing for the disabled by identifying requirements of public library disability services. This study aimed to investigate librarian service providers' awareness of library programs for the disabled in order to prepare a systematic plan for promoting such library services. Research methods used are a literature analysis and survey. First, the ratio of respondents with experience promoting activities and services for the disabled was less than 50%. Second, regarding methods for promoting library disability services, the respondents used library homepages, press releases, library user guides, library newsletters, and library pamphlets in that order. Third, when asked what kind of PR media the library disability service providers had experience with and how often they use it, library boards and banners were the most common response. Fourth, suggested improvements to the current design and content of PR materials included: clearer word choice (or greater understandability, more detailed descriptions, simpler layouts, and more interesting or eye-catching content in that order. Fifth, the library disability services which are in the most need of public relations were guide information for library disability services, Library and Information Service (DOI services and search services, using alternative materials and the library collection, and aiding the information search. Overall, when evaluating the promotion of disability services in Korea, the library's public relations for disabled services needs to improve because currently neither librarians nor the disabled community they are targeting has frequent or quality experience with it. Thus, the policy department for the library disability services must develop a variety of promotional strategies adjusted for each type of the disability and distribute PR materials to service providers individually, making sure to utilize effective PR
Drabble, Sarah J; Foster, Alexis; Horspool, Kimberley; Edwards, Louisa; Thomas, Clare; Salisbury, Chris
Background Evidence of benefit for telehealth for chronic conditions is mixed. Two linked randomized controlled trials tested the Healthlines Service for 2 chronic conditions: depression and high risk of cardiovascular disease (CVD). This new telehealth service consisted of regular telephone calls from nonclinical, trained health advisers who followed standardized scripts generated by interactive software. Advisors facilitated self-management by supporting participants to use Web-based resources and helped to optimize medication, improve treatment adherence, and encourage healthier lifestyles. Participants were recruited from primary care. The trials identified moderate (for depression) or partial (for CVD risk) effectiveness of the Healthlines Service. Objective An embedded qualitative study was undertaken to help explain the results of the 2 trials by exploring mechanisms of action, context, and implementation of the intervention. Methods Qualitative interview study of 21 staff providing usual health care or involved in the intervention and 24 patients receiving the intervention. Results Interviewees described improved outcomes in some patients, which they attributed to the intervention, describing how components of the model on which the intervention was based helped to achieve benefits. Implementation of the intervention occurred largely as planned. However, contextual issues in patients’ lives and some problems with implementation may have reduced the size of effect of the intervention. For depression, patients’ lives and preferences affected engagement with the intervention: these largely working-age patients had busy and complex lives, which affected their ability to engage, and some patients preferred a therapist-based approach to the cognitive behavioral therapy on offer. For CVD risk, patients’ motivations adversely affected the intervention whereby some patients joined the trial for general health improvement or from altruism, rather than
O'Cathain, Alicia; Drabble, Sarah J; Foster, Alexis; Horspool, Kimberley; Edwards, Louisa; Thomas, Clare; Salisbury, Chris
Evidence of benefit for telehealth for chronic conditions is mixed. Two linked randomized controlled trials tested the Healthlines Service for 2 chronic conditions: depression and high risk of cardiovascular disease (CVD). This new telehealth service consisted of regular telephone calls from nonclinical, trained health advisers who followed standardized scripts generated by interactive software. Advisors facilitated self-management by supporting participants to use Web-based resources and helped to optimize medication, improve treatment adherence, and encourage healthier lifestyles. Participants were recruited from primary care. The trials identified moderate (for depression) or partial (for CVD risk) effectiveness of the Healthlines Service. An embedded qualitative study was undertaken to help explain the results of the 2 trials by exploring mechanisms of action, context, and implementation of the intervention. Qualitative interview study of 21 staff providing usual health care or involved in the intervention and 24 patients receiving the intervention. Interviewees described improved outcomes in some patients, which they attributed to the intervention, describing how components of the model on which the intervention was based helped to achieve benefits. Implementation of the intervention occurred largely as planned. However, contextual issues in patients' lives and some problems with implementation may have reduced the size of effect of the intervention. For depression, patients' lives and preferences affected engagement with the intervention: these largely working-age patients had busy and complex lives, which affected their ability to engage, and some patients preferred a therapist-based approach to the cognitive behavioral therapy on offer. For CVD risk, patients' motivations adversely affected the intervention whereby some patients joined the trial for general health improvement or from altruism, rather than motivation to make lifestyle changes to address
Lanzini, Pietro; Thøgersen, John
behaviours over the six weeks, to identify instances of behavioural spillover from "green" purchase behaviour to other pro-environmental behaviours and to investigate if such spillover was affected by the nature of the intervention. The study revealed a positive spillover from "green" purchasing to other pro......This study tests hypotheses about behavioural spillover in the environmental domain as well as the impacts of monetary inducements and verbal praise on behavioural spillover by means of a field experiment. A sample of 194 students from a large university in Denmark were randomly allocated...... of environmentally relevant behaviours and after a six weeks intervention period where they were requested to keep track of their purchases by means of a shopping diary they answered a second survey with the same content as the first. This allowed us to analyse the change in self-reported pro- environmental...
Whitty, Megan; Nagel, Tricia; Ward, Linda; Jayaraj, Rama; Kavanagh, David
To explore the effect of education and training on the delivery of alcohol screening and brief intervention and referral to high-risk patients in a hospital setting. Main outcome measures included; delivery of training; practice change in relation to staff performing alcohol screening, brief intervention and referrals. Observational study design using mixed methods set in a tertiary referral hospital. Pre-post assessment of medical records and semi-structured interviews with key informants. Routine screening for substance misuse (9% pre / 71.4% post) and wellbeing concerns (6.6% pre / 15 % post) was more frequent following the introduction of resources and staff participation in educational workshops. There was no evidence of a concomitant increase in delivery of brief intervention or referrals to services. Implementation challenges, including time constraints and staff attitudes, and enablers such as collaboration and visible pathways, were identified. Rates of patient screening increased, however barriers to delivery of brief intervention and referrals remained. Implementation strategies targeting specific barriers and enablers to introducing interventions are both required to improve the application of secondary prevention for patients in acute settings. Educational training, formalised liaison between services, systematised early intervention protocols, and continuous quality improvement processes will progress service delivery in this area. © 2015 Public Health Association of Australia.
Zahra Salmani; Ali Zargham-Boroujeni; Mehrdad Salehi; Killeen, Therese K.; Effat Merghati-Khoei
Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural mod...
O'Hara, Blythe J; Bauman, Adrian E; Eakin, Elizabeth G; King, Lesley; Haas, Marion; Allman-Farinelli, Margaret; Owen, Neville; Cardona-Morell, Magnolia; Farrell, Louise; Milat, Andrew J; Phongsavan, Philayrath
The Get Healthy Information and Coaching Service® (GHS), a free government-funded telephone-delivered information and coaching service was launched in February 2009 by the Australian New South Wales state government. It represents the translation of research evidence applied in the real world (T4 or Phase 4 translation), aimed at addressing the modifiable risk factors associated with the overweight and obesity. In controlled settings, it has been established that telephone-based lifestyle counseling programs are efficacious in reducing anthropometric and behavioral risk factors. This article presents the GHS case study as a population-wide intervention and describes the quasi-experimental evaluation framework used to evaluate both the process (statewide implementation) and impact (effectiveness) of the GHS in a real-world environment. It details the data collection, measures, and statistical analysis required in assessing the process of implementation-reach and recruitment, marketing and promotion, service satisfaction, intervention fidelity, and GHS setting up and operations costs-and in assessing the impact of GHS-increasing physical activity, improving dietary practices, and reducing body weight and waist circumference. The comprehensive evaluation framework designed for the GHS provides a method for building effectiveness evidence of a rare translation of efficacy trial evidence into population-wide practice.
Interventions to significantly improve service uptake and retention of HIV-positive pregnant women and HIV-exposed infants along the prevention of mother-to-child transmission continuum of care: systematic review.
Vrazo, Alexandra C; Firth, Jacqueline; Amzel, Anouk; Sedillo, Rebecca; Ryan, Julia; Phelps, B Ryan
Despite the success of Prevention of Mother-to-Child Transmission of HIV (PMTCT) programmes, low uptake of services and poor retention pose a formidable challenge to achieving the elimination of vertical HIV transmission in low- and middle-income countries. This systematic review summarises interventions that demonstrate statistically significant improvements in service uptake and retention of HIV-positive pregnant and breastfeeding women and their infants along the PMTCT cascade. Databases were systematically searched for peer-reviewed studies. Outcomes of interest included uptake of services, such as antiretroviral therapy (ART) such as initiation, early infant diagnostic testing, and retention of HIV-positive pregnant and breastfeeding women and their infants. Interventions that led to statistically significant outcomes were included and mapped to the PMTCT cascade. An eight-item assessment tool assessed study rigour. CRD42017063816. Of 686 citations reviewed, 11 articles met inclusion criteria. Ten studies detailed maternal outcomes and seven studies detailed infant outcomes in PMTCT programmes. Interventions to increase access to antenatal care (ANC) and ART services (n = 4) and those using lay cadres (n = 3) were most common. Other interventions included quality improvement (n = 2), mHealth (n = 1), and counselling (n = 1). One study described interventions in an Option B+ programme. Limitations included lack of HIV testing and counselling and viral load monitoring outcomes, small sample size, geographical location, and non-randomized assignment and selection of participants. Interventions including ANC/ART integration, family-centred approaches, and the use of lay healthcare providers are demonstrably effective in increasing service uptake and retention of HIV-positive mothers and their infants in PMTCT programmes. Future studies should include control groups and assess whether interventions developed in the context of earlier 'Options' are
Patra, Suravi; Arun, Priti; Chavan, Bir Singh
Context: Parents of children with autism spectrum disorders (ASD) in India face a host of challenges, while seeking care which ranges from unavailability of information to difficulty in availing services. Aims: To develop a psycho-education intervention module for parents of children with ASD and to study its impact on parent stress and knowledge. Settings and Design: Child Guidance Clinic Department of Psychiatry, Government Medical College and Hospital, Chandigarh. Interventional study. Methodology: Parents of children diagnosed with ASD as per Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria, recruited through consecutive sampling. Total number of 18 participants participated in the two phase study. Phase I included preparation of a parent training module through a four stage process and Phase II was evaluation of impact of the final version of the module on parental stress and knowledge. Statistical Analysis: Wilcoxon Signed-Rank test using SPSS version 17.0. Results: There was an improvement in all the domains of parenting stress and knowledge. Social stress score and total stress score showed significant improvement. Conclusions: Parent psycho-education intervention module on ASD decreases parenting stress, and improves knowledge about ASD. Psycho-education intervention module is a feasible and acceptable way of parent empowerment. PMID:26752898
Full Text Available Context: Parents of children with autism spectrum disorders (ASD in India face a host of challenges, while seeking care which ranges from unavailability of information to difficulty in availing services. Aims: To develop a psycho-education intervention module for parents of children with ASD and to study its impact on parent stress and knowledge. Settings and Design: Child Guidance Clinic Department of Psychiatry, Government Medical College and Hospital, Chandigarh. Interventional study. Methodology: Parents of children diagnosed with ASD as per Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria, recruited through consecutive sampling. Total number of 18 participants participated in the two phase study. Phase I included preparation of a parent training module through a four stage process and Phase II was evaluation of impact of the final version of the module on parental stress and knowledge. Statistical Analysis: Wilcoxon Signed-Rank test using SPSS version 17.0. Results: There was an improvement in all the domains of parenting stress and knowledge. Social stress score and total stress score showed significant improvement. Conclusions: Parent psycho-education intervention module on ASD decreases parenting stress, and improves knowledge about ASD. Psycho-education intervention module is a feasible and acceptable way of parent empowerment.
Crengle, Sue; Smylie, Janet; Kelaher, Margaret; Lambert, Michelle; Reid, Susan; Luke, Joanne; Anderson, Ian; Harré Hindmarsh, Jennie; Harwood, Matire
Cardiovascular diseases (CVD) are leading causes of mortality and morbidity among Indigenous people in New Zealand, Australia and Canada and are a major driver of the inequities in life expectancy between Indigenous and non-Indigenous people in these countries. Evidence-based pharmaceutical management of CVD can significantly reduce mortality and morbidity for persons diagnosed with CVD or for those at intermediate or high risk of CVD. Health literacy has been identified as a major barrier in the communication and implementation of appropriate pharmaceutical management plans for CVD. Addressing health literacy is particularly relevant in Indigenous populations where there are unique health and adult literacy challenges. This study will examine the effect of a customized, structured CVD medication programme, delivered by health professionals, on the health literacy of Indigenous people with, or at risk, of CVD. Primary outcomes are patient's knowledge about CVD medications; secondary outcomes examine changes in health literacy skills and practices. The study will employ a multi-site pre-post design with multiple measurement points to assess intervention efficacy. Participants will be recruited from four Indigenous primary care services in Australia, Canada and New Zealand. Three educational sessions will be delivered over four weeks. A tablet application will support the education sessions and produce a customized pill card for each participant. Participants will be provided with written information about CVD medications. Medication knowledge scores, and specific health literacy skills and practices will be assessed before and after the three sessions. Statistical analyses will identify significant changes in outcomes over each session, and from the pre-session one to post-session three time points. This study will make an important contribution to understanding the effect of a structured primary care-based intervention on CVD health literacy in Indigenous
Martin, C Andrew; Upvall, Michele J
We present the findings of a qualitative pilot study designed to describe the experience of HIV medication adherence using a mobile phone application. Nine semi-structured focus group discussions were conducted over a 3-month period at an AIDS Services Organization in Central Texas. The data were analyzed following the principles of thematic analysis. During analysis, four themes were identified, and relations between these themes were delineated to reflect the experiences of the 23 participants. The mobile phone application, Care4Today™ Mobile Health Manager, was the intervention tool. Collection of focus group discussion outcomes over a 3-month period with baseline versus end-of-study data determined the feasibility and acceptability of this medication adherence intervention. The findings suggest that when individuals are offered the necessary resources, such as a mobile phone medication reminder application, they may have greater success in performing the behavior. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Solomonides, Ian Paul
The aim of the research was to: investigate the effect of a learning intervention on the Approach to Study of first year engineering degree students. The learning intervention was a local programme of learning to learn' workshops designed and facilitated by the author. The primary aim of these was to develop students' Approaches to Study. Fifty-three first year engineering undergraduates at The Nottingham Trent University participated in the workshops. Approaches to Study were quantified using data obtained from the Revised Approach to Study Inventory (RASI) which was also subjected to a validity and reliability study using local data. Quantitative outcomes were supplemented using a qualitative analysis of essays written by students during the workshops. These were analysed for detail regarding student Approach to Study. It was intended that any findings would inform the local system of Engineering Education, although more general findings also emerged, in particular in relation to the utility of the research instrument. It was concluded that the intervention did not promote the preferential Deep Approach and did not affect Approaches to Study generally as measured by the RASI. This concurred with previous attempts to change student Approaches to Study at the group level. It was also established that subsequent years of the Integrated Engineering degree course are associated with progressively deteriorating Approaches to Study. Students who were exposed to the intervention followed a similar pattern of deteriorating Approaches suggesting that the local course context and its demands had a greater influence over the Approach of students than the intervention did. It was found that academic outcomes were unrelated to the extent to which students took a Deep Approach to the local assessment demands. There appeared therefore to be a mis-match between the Approach students adopted to pass examinations and those that are required for high quality learning outcomes. It is
Corr, Catherine; Santos, Rosa Milagros; Fowler, Susan A.
The Individuals With Disabilities Education Act mandates that very young children with disabilities be served through Part C services. Families of young children with disabilities who are also living in poverty are often the primary recipients of these services. To better understand the experiences of families, particularly those living in…
... treatment services to women, infants, and children without disruption from Orlando Health Incorporated's HUG...: Critical funding for HIV/AIDS care and treatment to the target populations in Orange County, Orlando... and treatment services. It has administered its own HRSA Ryan White HIV/AIDS Program Part C EIS Grant...
Heo, Misook; Song, Jung-Sook; Seol, Moon-Won
The authors examined the needs of digital information service web portal users. More specifically, the needs of Korean cultural portal users were examined as a case study. The conceptual framework of a web-based portal is that it is a complex, web-based service application with characteristics of information systems and service agents. In…
Hamlet, Benjamin R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Encarnacao, Andre Villanova [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Harris, James M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Young, Christopher J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
This report is a progress update on the USNDC Modernization Service Oriented Architecture (SOA) study describing results from Inception Iteration 1, which occurred between October 2012 and March 2013. The goals during this phase are 1) discovering components of the system that have potential service implementations, 2) identifying applicable SOA patterns for data access, service interfaces, and service orchestration/choreography, and 3) understanding performance tradeoffs for various SOA patterns
Full Text Available Abstract Background Malaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT, a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR approach to priority setting in Zambia, Tanzania and Kenya. Methods This paper is based on baseline in-depth interviews (IDIs conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership. Results Conflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both
In this article I discuss the findings from a case study focusing on processes involving pupils to bring about health promotion changes. The case study is related to a large EU intervention project aiming to promote health and wellbeing among children (4-16 years), ‘Shape Up: a school...... study showed that, if given sufficient guidance, children can act as agents of health promoting changes. The main arena for pupils’ influence was the pupils’ council. Pupils were meaningfully involved in two actions, which targeted road safety around the school and a playground for a disadvantaged...
Full Text Available Abstract Background In order to increase the chances of success in new interventions in healthcare, it is generally recommended to tailor the intervention to the target setting and the target professionals. Nonetheless, pre-intervention studies are rarely conducted or are very limited in scope. Moreover, little is known about how to integrate the results of a pre-intervention study into an intervention. As part of a project to develop an intervention aimed at improving care for the elderly in France, a pre-intervention study was conducted to systematically gather data on the current practices, issues, and expectations of healthcare professionals and managers in order to determine the defining features of a successful intervention. Methods A qualitative study was carried out from 2004 to 2006 using a grounded theory approach and involving a purposeful sample of 56 healthcare professionals and managers in Paris, France. Four sources of evidence were used: interviews, focus groups, observation, and documentation. Results The stepwise approach comprised three phases, and each provided specific results. In the first step of the pre-intervention study, we gathered data on practices, perceived issues, and expectations of healthcare professionals and managers. The second step involved holding focus groups in order to define the characteristics of a tailor-made intervention. The third step allowed validation of the findings. Using this approach, we were able to design and develop an intervention in elderly care that met the professionals' and managers' expectations. Conclusion This article reports on an in-depth pre-intervention study that led to the design and development of an intervention in partnership with local healthcare professionals and managers. The stepwise approach represents an innovative strategy for developing tailored interventions, particularly in complex domains such as chronic care. It highlights the usefulness of seeking out the
Freitas, Mfl; Santos, Jm; Fuks, A; Bezerra, Acb; Azevedo, Tdpl
Minimal Intervention Dentistry (MID) is an effective treatment approach with increasing acceptance among dental professionals. This study aimed to evaluate the MID impact on Dentistry by analyzing procedures performed on patients treated at a Pediatric Dentistry Graduate Program clinic which implemented MID. The number of procedures including sealants, modified atraumatic restorative treatment (mART), resin crowns, direct pulp capping, pulpotomy, pulpectomy, and deciduous/ permanent extractions from 333 pediatric patients treated between the years 2001 to 2003 and 2008 to 2010 in Distrito Federal, Brazil were analyzed. Statistical analysis involved chi-square and G Williams tests. 783 procedures were analyzed and demonstrated that there was a significant reduction of sealant placement in the last triennium when compared to the first one (ppulpectomy (p=0.0002). Based on the results, MID represented a positive impact on the intervention on caries lesions in patients, mainly reflected by the significant reduction in the number of direct pulp capping, pulpotomy and pulpectomy.
Philippa A Jackson
Full Text Available Functional near infrared spectroscopy (NIRS is a non-invasive optical imaging technique used to monitor cerebral blood flow (CBF and by proxy neuronal activation. The use of NIRS in nutritional intervention studies is a relatively novel application of this technique, with only a small, but growing, number of trials published to date. These trials—in which the effects on CBF following administration of dietary components such as caffeine, polyphenols and omega-3 polyunsaturated fatty acids are assessed—have successfully demonstrated NIRS as a sensitive measure of change in haemodynamic response during cognitive tasks in both acute and chronic treatment intervention paradigms. The existent research in this area has been limited by the constraints of the technique itself however advancements in the measurement technology, paired with studies endeavouring increased sophistication in number and locations of channels over the head should render the use of NIRS in nutritional interventions particularly valuable in advancing our understanding of the effects of nutrients and dietary components on the brain.
Hansen, Anca Daniela; Altin, Müfit
The objective of this report is to illustrate and analyse, by means of simulation test cases, the impact of wind power advanced ancillary services, like inertial response (IR), power oscillation damping (POD) and synchronising power (SP) on the power system. Generic models for wind turbine, wind...... power plant and power system are used in the investigation....
Noyes, Jane; Hendry, Margaret; Lewin, Simon; Glenton, Claire; Chandler, Jackie; Rashidian, Arash
To compare the contribution of "trial-sibling" and "unrelated" qualitative studies in complex intervention reviews. Researchers are using qualitative "trial-sibling" studies undertaken alongside trials to provide explanations to understand complex interventions. In the absence of qualitative "trial-sibling" studies, it is not known if qualitative studies "unrelated" to trials are helpful. Trials, "trial-sibling," and "unrelated" qualitative studies looking at three health system interventions were identified. We looked for similarities and differences between the two types of qualitative studies, such as participants, intervention delivery, context, study quality and reporting, and contribution to understanding trial results. Reporting was generally poor in both qualitative study types. We detected no substantial differences in participant characteristics. Interventions in qualitative "trial-sibling" studies were delivered using standardized protocols, whereas interventions in "unrelated" qualitative studies were delivered in routine care. Qualitative "trial-sibling" studies alone provided insufficient data to develop meaningful transferrable explanations beyond the trial context, and their limited focus on immediate implementation did not address all phenomena of interest. Together, "trial-sibling" and "unrelated" qualitative studies provided larger, richer data sets across contexts to better understand the phenomena of interest. Findings support inclusion of "trial-sibling" and "unrelated" qualitative studies to explore complexity in complex intervention reviews. Copyright © 2016 Elsevier Inc. All rights reserved.
Abbott, M; Bellringer, M; Vandal, A C; Hodgins, D C; Battersby, M; Rodda, S N
The primary purpose of this study is to evaluate the relative effectiveness of 2 of the best developed and most promising forms of therapy for problem gambling, namely face-to-face motivational interviewing (MI) combined with a self-instruction booklet (W) and follow-up telephone booster sessions (B; MI+W+B) and face-to-face cognitive-behavioural therapy (CBT). This project is a single-blind pragmatic randomised clinical trial of 2 interventions, with and without the addition of relapse-prevention text messages. Trial assessments take place pretreatment, at 3 and 12 months. A total of 300 participants will be recruited through a community treatment agency that provides services across New Zealand and randomised to up to 10 face-to-face sessions of CBT or 1 face-to-face session of MI+W+up to 5 B. Participants will also be randomised to 9 months of postcare text messaging. Eligibility criteria include a self-perception of having a current gambling problem and a willingness to participate in all components of the study (eg, read workbook). The statistical analysis will use an intent-to-treat approach. Primary outcome measures are days spent gambling and amount of money spent per day gambling in the prior month. Secondary outcome measures include problem gambling severity, gambling urges, gambling cognitions, mood, alcohol, drug use, tobacco, psychological distress, quality of life, health status and direct and indirect costs associated with treatment. The research methods to be used in this study have been approved by the Ministry of Health, Health and Disability Ethics Committees (HDEC) 15/CEN/99. The investigators will provide annual reports to the HDEC and report any adverse events to this committee. Amendments will also be submitted to this committee. The results of this trial will be submitted for publication in peer-reviewed journals and as a report to the funding body. Additionally, the results will be presented at national and international conferences
Aust, Birgit; Flyvholm, Mari-Ann
Targeting occupational health and safety interventions to different groups of employees and sectors is important. The aim of this study was to explore the environment-intervention fit of a Danish psychosocial work environment intervention program for the residential and home care sector. Focus group interviews with employees and interviews with mangers were conducted at 12 selected workplaces and a questionnaire survey was conducted with managers at all 115 workplaces. The interventions enhanced the probability of employees experiencing more “good” work days, where they could make a difference to the lives of clients. The interventions may therefore be characterized as culturally compelling and having a good fit with the immediate work environment of employees. The interventions furthermore seemed to fit well with the wider organizational environment and with recent changes in the societal and economic context of workplaces. However, some workplaces had difficulties with involving all employees and adapting the interventions to the organization of work. The findings suggest that flexibility and a variety of strategies to involve all employees are important aspects, if interventions are to fit well with the care sector. The focus on employees' conceptualization of a “good” work day may be useful for intervention research in other sectors. PMID:26380356
Lee, Sue Ann S; Hall, Brittany; Sancibrian, Sherry
The goal of the current study was to examine the feasibility of a telepractice intervention to improve phonological awareness skills in children with hearing loss as compared to a conventional in-person intervention. Twenty children with hearing loss participated in this study. Two groups of ten children each received a supplemental phonological awareness intervention either via telepractice or an in-person service delivery model. Within each of the two groups, five children were enrolled in preschool or kindergarten and five children were enrolled in first or second grade. The two groups of children demonstrated similar phonological awareness, non-verbal IQ, and vocabulary skills during pre-tests. After a 12-week intervention children with hearing loss showed improved phonological awareness skills as measured by a standardized post-test. No significant differences were found between the performance of the telepractice group and in-person group. Nor was a significant interaction found between the two age groups (PreK/K vs. 1st /2nd grade) and the two types of service delivery models (in-person vs. telepractice). The results suggest that a telepractice service delivery model is feasible for young children with hearing loss, and that telepractice may be as effective as in-person intervention in improving phonological awareness skills.
Sailer, Anna M., E-mail: email@example.com; Haan, Michiel W. de, E-mail: firstname.lastname@example.org; Graaf, Rick de, E-mail: email@example.com; Zwam, Willem H. van, E-mail: firstname.lastname@example.org [Maastricht University Medical Center, Department of Radiology (Netherlands); Schurink, Geert Willem H., E-mail: email@example.com [Maastricht University Medical Center, Department of Surgery (Netherlands); Nelemans, Patricia J., E-mail: firstname.lastname@example.org [Maastricht University Medical Centre, Department of Epidemiology (Netherlands); Wildberger, Joachim E., E-mail: email@example.com; Das, Marco, E-mail: firstname.lastname@example.org [Maastricht University Medical Center, Department of Radiology (Netherlands)
PurposeThis study was designed to evaluate the feasibility of endovascular guidance by means of live fluoroscopy fusion with magnetic resonance angiography (MRA) and computed tomography angiography (CTA).MethodsFusion guidance was evaluated in 20 endovascular peripheral artery interventions in 17 patients. Fifteen patients had received preinterventional diagnostic MRA and two patients had undergone CTA. Time for fluoroscopy with MRA/CTA coregistration was recorded. Feasibility of fusion guidance was evaluated according to the following criteria: for every procedure the executing interventional radiologists recorded whether 3D road-mapping provided added value (yes vs. no) and whether PTA and/or stenting could be performed relying on the fusion road-map without need for diagnostic contrast-enhanced angiogram series (CEAS) (yes vs. no). Precision of the fusion road-map was evaluated by recording maximum differences between the position of the vasculature on the virtual CTA/MRA images and conventional angiography.ResultsAverage time needed for image coregistration was 5 ± 2 min. Three-dimensional road-map added value was experienced in 15 procedures in 12 patients. In half of the patients (8/17), intervention was performed relying on the fusion road-map only, without diagnostic CEAS. In two patients, MRA roadmap showed a false-positive lesion. Excluding three patients with inordinate movements, mean difference in position of vasculature on angiography and MRA/CTA road-map was 1.86 ± 0.95 mm, implying that approximately 95 % of differences were between 0 and 3.72 mm (2 ± 1.96 standard deviation).ConclusionsFluoroscopy with MRA/CTA fusion guidance for peripheral artery interventions is feasible. By reducing the number of CEAS, this technology may contribute to enhance procedural safety.
Tian, Zengmin; Jia, Bo; Lu, Wangsheng; Hui, Rui
Recently, robotic systems have been introduced as a useful method for surgical procedures. But in the field of vascular interventional therapy, the development of robotic system is slower. The purpose of the study is to verify the reliability and safety of vascular interventional robotic system used in angiography, by the way of in vitro preliminary experiments and animal experiments. The approach is to employ a proprietary vascular interventional robot system to complete glass vessel models and animal angiogram experiments. This robot system consists of a console port (remote steering system), an assistant port (propelled and rotation system) and a hydraulic fixing device, upon which surgeons control remotely to make go forward and rotate in the glass vessel models and animal vessels, on the 3D operation interface. Consequently, the operation time and success rate are counted and evaluated. In the glass vessel model experiments, the Catheter can enter various kinds of vessel models with inside diameter length greater than 3mm and angle less than 90(o). In the animal (adult dogs) experiments, surgeons can accomplish smoothly the angiogram of the renal artery, the vertebral renal and the arteria carotis communis, without any complications of surgery. The angiogram by using vascular interventional robot system is safe and reliable. Surgeons can finish the angiogram in part by remote operation, and the result of angiogram can meet a number of simple expectations. However without wire control and force feedback systems, the applicability of this kind of robot system is not flexible enough and need to be improved in the future.
Wilson Graeme B
Full Text Available Abstract Background Risky drinking in pregnancy by UK women is likely to result in many alcohol-exposed pregnancies. Studies from the USA suggest that brief intervention has promise for alcohol risk reduction in antenatal care. However, further research is needed to establish whether this evidence from the USA is applicable to the UK. This pilot study aims to investigate whether pregnant women can be recruited and retained in a randomized controlled trial of brief intervention aimed at reducing risky drinking in women receiving antenatal care. Methods The trial will rehearse the parallel-group, non-blinded design and procedures of a subsequent definitive trial. Over 8 months, women aged 18 years and over (target number 2,742 attending their booking appointment with a community midwife (n = 31 in north-east England will be screened for alcohol consumption using the consumption questions of the Alcohol Use Disorders Identification Test (AUDIT-C. Those screening positive, without a history of substance use or alcohol dependence, with no pregnancy complication, and able to give informed consent, will be invited to participate in the trial (target number 120. Midwives will be randomized in a 1:1 ratio to deliver either treatment as usual (control or structured brief advice and referral for a 20-minute motivational interviewing session with an alcohol health worker (intervention. As well as demographic and health information, baseline measures will include two 7-day time line follow-back questionnaires and the EuroQoL EQ-5D-3 L questionnaire. Measures will be repeated in telephone follow-ups in the third trimester and at 6 months post-partum, when a questionnaire on use of National Health Service and social care resources will also be completed. Information on pregnancy outcomes and stillbirths will be accessed from central health service records before the follow-ups. Primary outcomes will be rates of eligibility, recruitment, intervention
McCalman, Janya; Heyeres, Marion; Campbell, Sandra; Bainbridge, Roxanne; Chamberlain, Catherine; Strobel, Natalie; Ruben, Alan
Primary healthcare services in Australia, Canada, New Zealand and the United States have embraced the concept of family-centred care as a promising approach to supporting and caring for the health of young Indigenous children and their families. This scoping review assesses the quality of the evidence base and identifies the published literature on family- centred interventions for Indigenous early childhood wellbeing. Fourteen electronic databases, grey literature sources and the reference lists of Indigenous maternal and child health reviews were searched to identify relevant publications from 2000 to 2015. Studies were included if the intervention was: 1) focussed on Indigenous children aged from conception to 5 years from the abovementioned countries; 2) led by a primary healthcare service; 3) described or evaluated; and 4) scored greater than 50% against a validated scale for family-centredness. The study characteristics were extracted and quality rated. Reported aims, strategies, enablers and outcomes of family-centredcare were identified using grounded theory methods. Eighteen studies (reported in 25 publications) were included. Three were randomised controlled studies; most were qualitative and exploratory in design. More than half of the publications were published from 2012 to 2015. The overarching aim of interventions was to promote healthy families. Six key strategies were to: support family behaviours and self- care, increase maternal knowledge, strengthen links with the clinic, build the Indigenous workforce, promote cultural/ community connectedness and advocate for social determinants of health. Four enablers were: competent and compassionate program deliverers, flexibility of access, continuity and integration of healthcare, and culturally supportive care. Health outcomes were reported for Indigenous children (nutritional status; emotional/behavioural; and prevention of injury and illness); parents/caregivers (depression and substance abuse; and
Gellatly, Judith; Pedley, Rebecca; Molloy, Christine; Butler, Jennifer; Lovell, Karina; Bee, Penny
Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can substantially impact upon quality of life and everyday functioning. Guidelines recommend pharmacological and psychological treatments, using a cognitive behaviour therapy approach (CBT) including exposure and response prevention, but access has generally been poor. Low intensity psychological interventions have been advocated. The evidence base for these interventions is emerging but there is a paucity of information regarding practitioners' perceptions and experiences of supporting individuals with OCD using this approach. Qualitative interviews were undertaken with psychological wellbeing practitioners (PWPs) (n = 20) delivering low intensity psychological interventions for adults with OCD within the context of a large pragmatic effectiveness trial. Interviews explored the feasibility and acceptability of delivering two interventions; guided self-help and supported computerised cognitive behaviour therapy (cCBT), within Improving Access to Psychological Therapies (IAPT) services in NHS Trusts. Interviews were recorded with consent, transcribed and analysed using thematic analysis. PWPs acknowledged the benefits of low intensity psychological interventions for individuals experiencing OCD symptoms on an individual and population level. Offering low intensity support provided was perceived to have the opportunity to overcome existing service barriers to access treatment, improve patient choice and flexibility. Professional and service relevant issues were also recognised including self-beliefs about supporting people with OCD and personal training needs. Challenges to implementation were recognised in relation to practitioner resistance and intervention delivery technical complications. This study has provided insight into the implementation of new low intensity approaches to the management of OCD within existing mental health services. Benefits from a practitioner, service
Osilla, Karen Chan; Trail, Thomas E; Pedersen, Eric R; Gore, Kristie L; Tolpadi, Anagha; Rodriguez, Lindsey M
Concerned partners (CPs) of service members and veterans who misuse alcohol face help-seeking barriers and mental health problems. We used multiple regression to evaluate the efficacy of Partners Connect, a four-session web-based intervention (WBI) to address military CPs' mental health and communication. We randomized 312 CPs to the WBI or a control group. Five months later, WBI CPs reported significant reductions in their anxiety and increases in their social support compared to control CPs. Intervention dose was also associated with improved WBI CP outcomes. Partners Connect appears to fill a need for families who face help-seeking barriers and provides an alternative to traditional care for those who may not otherwise seek help. © 2017 American Association for Marriage and Family Therapy.
Full Text Available Abstract Background Faced with a life-threatening illness, such as cancer, many patients develop stress symptoms, i.e. avoidance behaviour, intrusive thoughts and worry. Stress management interventions have proven to be effective; however, they are mostly performed in group settings and it is commonly breast cancer patients who are studied. We hereby present the design of a randomized controlled trial (RCT evaluating the effectiveness and cost-effectiveness of an individual stress-management intervention with a stepped-care approach in several cancer diagnoses. Method Patients (≥ 18 years with a recent diagnosis of breast cancer, colorectal cancer, lymphoma, prostate cancer or testicle cancer and scheduled for adjuvant/curative oncology treatment, will consecutively be included in the study. In this prospective longitudinal intervention study with a stepped-care approach, patients will be randomized to control, treatment as usual, or an individual stress-management intervention in two steps. The first step is a low-intensity stress-management intervention, given to all patients randomized to intervention. Patients who continue to report stress symptoms after the first step will thereafter be given more intensive treatment at the second step of the programme. In the intervention patients will also be motivated to be physically active. Avoidance and intrusion are the primary outcomes. According to the power analyses, 300 patients are planned to be included in the study and will be followed for two years. Other outcomes are physical activity level, sleep duration and quality recorded objectively, and anxiety, depression, quality of life, fatigue, stress in daily living, and patient satisfaction assessed using valid and standardized psychometric tested questionnaires. Utilization of hospital services will be derived from the computerized patient administration systems used by the hospital. The cost-effectiveness of the intervention will be
Whitehead, Phillip J; Drummond, Avril E E; Walker, Marion F; Parry, Ruth H
There is a growing demand for services whereby individuals receive assistance from care workers for personal care within the home. This has led to the development of re-ablement or restorative homecare services that provide time-limited input aimed at reducing dependency in personal activities of daily living, and preventing or delaying the need for further homecare support. However, little is currently known about how such interventions are configured, or how they may affect individuals' ability to carry out personal care independently. We will seek to identify studies that compare an intervention designed to reduce dependency in personal activities of daily living with routine input or usual care as the control. We will include randomised controlled trials, nonrandomised controlled trials, and controlled before and after studies. We will also include interrupted time series studies. We shall search electronic databases in addition to searching for ongoing and unpublished studies, and where appropriate will contact key authors. Two reviewers will independently screen articles for inclusion; will assess risk of bias using quality assessment tools; and will carry out data extraction using pre-prepared forms. Any disagreements, at any stage, will be resolved by discussion and the involvement of a third reviewer if needed. We will produce a narrative summary of the results. A meta-analysis will be conducted if sufficient data are available of appropriate quality and comparability. The findings from this review will inform future practice within homecare re-ablement services; will inform policy decisions about the structure, organisation and content of such services; and will identify areas where further research is warranted. This review protocol has been registered on the PROSPERO database (CRD42013004163).
Mohammad Javad Akbarian Bafghi
Full Text Available Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.
Barrio, Brenda L.; Combes, Bertina H.
Revisions to Individuals with Disabilities Education Improvement Act (IDEIA) proposed alternative models, such as Response to Intervention (RTI), as a preventive measure that supports students at risk. As teachers' roles evolve in response to RTI, teacher preparation programs must adjust their focus and curriculum accordingly. A mixed-methods…
Hayward, Diane W.; Gale, Catherine M.; Eikeseth, Svein
Outcome research has shown that early and intensive behavioural intervention (ABA) may improve intellectual, language and adaptive functioning in children with autism. However, research has also indicated that not all ABA provisions are equally effective. Therefore, it may be beneficial to describe the key variables that are common to programmes…
Puig, Victoria I.
This position statement considers family languages, family cultures, and partnerships between family members and early intervention (EI) professionals as intimately interconnected and resources to be accessed when serving young children with special needs and their families. It presents theory and an overview of works that examine the impact of…
Willging, Cathleen E.; Trott, Elise M.; Fettes, Danielle; Gunderson, Lara; Green, Amy E.; Hurlburt, Michael S.; Aarons, Gregory A.
Objective: We examine how frontline workers and supervisors delivering a research-supported intervention (RSI) to reduce child neglect negotiated system-related challenges, the pragmatics of RSI implementation, and their professional identities and relationships with clients. Methods: We conducted semi-structured interviews, small group…
Zabel, Robert H.
The paper traces the origins of the definitions of autism, notes controversies over its etiology, and discusses the wide variety of intervention approaches used. Psychoeducational approaches, such as play therapy and B. Bettelheim's psychoanalytic approach, are described and criticized in terms of premises and the anecdotal nature of evaluation…
Johnsen, Susan K.; Parker, Sonia L.; Farah, Yara N.
Response to intervention (RTI) was included in the 2004 reauthorization of the Individuals With Disabilities Education Act (IDEA), specifically as part of an assessment process to determine if a child has a disability. Although IDEA's focus is on students with disabilities, 10 states have developed policies that attend to students with gifts and…
Dion, Jacinthe; Kennedy, Allison; Cloutier, Paula; Gray, Clare
An innovative crisis intervention programme was created at the Children's Hospital of Eastern Ontario in Canada in order to provide emergency assessments for youth presenting with mental health crises. The current investigation presents an overview of the programme and examines the emergency staff's perception and satisfaction with it.…
Dennis-Small, Lucretia; Cohen, Miye
An evaluation was made of the Multidisciplinary Institute for Child Sexual Abuse Intervention and Treatment, a project established mainly to develop a curriculum for interdisciplinary child sexual abuse training, change attitudes and increase knowledge and skills of trainees, and promote a team approach toward training and case management among…
Full Text Available Abstract Background Early intervention teams attempt to improve outcome in schizophrenia through earlier detection and the provision of phase-specific treatments. Whilst the number of early intervention teams is growing, there is a lack of clarity over their essential structural and functional elements. Methods A 'Delphi' exercise was carried out to identify how far there was consensus on the essential elements of early intervention teams in a group of 21 UK expert clinicians. Using published guidelines, an initial list was constructed containing 151 elements from ten categories of team structure and function. Results Overall there was expert consensus on the importance of 136 (90% of these elements. Of the items on which there was consensus, 106 (70.2% were rated essential, meaning that in their absence the functioning of the team would be severely impaired. Conclusion This degree of consensus over essential elements suggests that it is reasonable to define a model for UK early intervention teams, from which a measure of fidelity could be derived.
Mcleod, Sharynne; Baker, Elise
A survey of 231 Australian speech-language pathologists (SLPs) was undertaken to describe practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders (SSD). The participants typically worked in private practice, education, or community health settings and 67.6% had a waiting list for services. For each child, most of the SLPs spent 10-40 min in pre-assessment activities, 30-60 min undertaking face-to-face assessments, and 30-60 min completing paperwork after assessments. During an assessment SLPs typically conducted a parent interview, single-word speech sampling, collected a connected speech sample, and used informal tests. They also determined children's stimulability and estimated intelligibility. With multilingual children, informal assessment procedures and English-only tests were commonly used and SLPs relied on family members or interpreters to assist. Common analysis techniques included determination of phonological processes, substitutions-omissions-distortions-additions (SODA), and phonetic inventory. Participants placed high priority on selecting target sounds that were stimulable, early developing, and in error across all word positions and 60.3% felt very confident or confident selecting an appropriate intervention approach. Eight intervention approaches were frequently used: auditory discrimination, minimal pairs, cued articulation, phonological awareness, traditional articulation therapy, auditory bombardment, Nuffield Centre Dyspraxia Programme, and core vocabulary. Children typically received individual therapy with an SLP in a clinic setting. Parents often observed and participated in sessions and SLPs typically included siblings and grandparents in intervention sessions. Parent training and home programs were more frequently used than the group therapy. Two-thirds kept up-to-date by reading journal articles monthly or every 6 months. There were many similarities with
Fisher, Helen L; Roberts, Anna; Day, Fern; Reynolds, Nicky; Iacoponi, Eduardo; Garety, Philippa A; Craig, Thomas K J; McGuire, Philip; Valmaggia, Lucia; Power, Paddy
To investigate the clinical and social correlates of a lifetime history of crime victimization among first-episode psychosis patients at entry to an Early Intervention Service and following 18 months of specialist care. Face-to-face interviews were conducted with 149 individuals who presented to an Early Intervention Service for the first time with psychosis in the London borough of Lambeth, UK. A range of demographic and clinical measures were completed including self-reported history of victimization along with the type of crime and its subjective effect on the patient. Clinical and functional outcomes at 18-month follow up were ascertained from clinical case notes by a psychiatrist. A large proportion of patients (n = 64, 43%) reported a history of crime victimization. This was associated with significantly higher levels of depression and substance misuse at initial presentation. Being a victim of a crime was not significantly associated with poorer clinical or functional outcomes after 18 months of specialist care. However, non-significant differences were found for those who reported crime victimization in terms of their increased use of illegal substances or having assaulted someone else during the follow-up period. Past experience of being a victim of crime appears to be common in patients presenting for the first time with psychosis and is associated with increased likelihood of comorbidity. Thus, Early Intervention Services should consider screening for past victimization and be prepared to deal with comorbid problems. The impact of crime victimization on clinical and functional outcomes requires investigation over a longer period of time. © 2015 Wiley Publishing Asia Pty Ltd.
Roberts, Seren Haf; Bailey, Jois Elisabeth
To explore incentives and barriers to an educational lifestyle intervention for people with severe mental illness. Social and lifestyle factors along with long-term antipsychotic therapy contribute to poorer physical health in people with severe mental illness. Behavioural lifestyle interventions for this clinical group have shown some benefit. Evidence relating to the incentives and barriers to interventions is limited. An ethnographic qualitative study was undertaken. Data collection was carried out through participant observations and semi-structured interviews with eight mental health service users attending, or previously attended, a group-based lifestyle intervention. Interview data were collected between September 2008-April 2009 and observation data were collected between September-December 2009. Participant observation highlighted environment, facilitator style, group ownership, group cohesion, information and learning, incentives and barriers as important. Participant interviews identified weight management, social networking, information and communication, role of healthcare professionals and perceived benefits as key themes. This study provides evidence about the incentives and barriers to lifestyle interventions from service users' perspective, which should inform developments to improve the delivery of lifestyle interventions for this group. © 2013 Blackwell Publishing Ltd.
Siller, Michael; Morgan, Lindee; Turner-Brown, Lauren; Baggett, Kathleen M.; Baranek, Grace T.; Brian, Jessica; Bryson, Susan E.; Carter, Alice S.; Crais, Elizabeth R.; Estes, Annette; Kasari, Connie; Landa, Rebecca J.; Lord, Catherine; Messinger, Daniel S.; Mundy, Peter; Odom, Samuel L.; Reznick, J. Steven; Roberts, Wendy; Rogers, Sally J.; Schertz, Hannah H.; Smith, Isabel M.; Stone, Wendy L.; Watson, Linda R.; Wetherby, Amy M.; Yoder, Paul J.; Zwaigenbaum, Lonnie
Given recent advances in science, policy, and practice of early identification in autism spectrum disorder (ASD), questions about the effectiveness of early intervention have far-reaching service and policy implications. However, rigorous research evaluating the efficacy and effectiveness of intervention programs for toddlers with ASD faces a…
Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes.
Burns, Clare L; Ward, Elizabeth C; Hill, Anne J; Kularatna, Sanjeewa; Byrnes, Joshua; Kenny, Lizbeth M
The purpose of this study was to present our evaluation of a new speech pathology telepractice service supporting the swallowing and communication management of patients with head and neck cancer. A multicenter randomized controlled trial was conducted within a large public cancer service. Referrals from speech pathologists at 3 regional sites (spoke sites) were managed by a specialist clinician from a cancer center (hub site) either via standard care (phone/email support/appointments at the hub site) or a newly established telepractice service (online consultation between the hub site and spoke site). Eighty-two referrals (39 for standard care and 43 for telepractice care) were managed. Service efficiency favoring the telepractice model was reported with a significant reduction in the number (p = .004) and duration (p = .024) of contact events required to manage the referrals. Higher consumer and clinician satisfaction was also reported for the telepractice service. A speech pathology telepractice service benefits both the patient and health provider through higher service efficiency and treatment satisfaction. © 2017 Wiley Periodicals, Inc. Head Neck 39: 932-939, 2017. © 2017 Wiley Periodicals, Inc.
Lear, S A; Ignaszewski, A; Laquer, E A; Pritchard, P H; Frohlich, J J
Long-term management of the lifestyles of cardiac patients who have completed a cardiac rehabilitation program (CRP), and the risks that may develop for future health problems, have not been extensively reported. The purpose of this pilot study of graduates of CRPs was to: (a) assess lifestyle and risk factor trends, (b) test certain protocols, and (c) identify the challenges and limitations in managing lifestyles and risk factors. A convenience sample of 49 people with ischemic heart disease (IHD) was randomized to a Lifestyle Management Intervention (LMI) group and a Usual Care (UC) group and followed for 6 months. Patients assigned to the LMI group underwent six additional exercise sessions and participated in telephone follow-ups and a counseling session. Patients in the UC group were assessed at baseline and at the end of 6 months. Of the original 49 participants, 17 in the LMI group and 19 in the UC group completed the study. Patients in the LMI group showed significant reductions in total cholesterol and LDL-C from baseline at 6 months. Diastolic blood pressure was decreased significantly in the UC group. The study identified the challenges of lifestyle intervention and found that favorable risk factor modifications are possible for patients who have completed a CRP.
Cataloged from PDF version of article. Increased competition and Turkey's entrance to the Customs Union with the European Union has boosted a quality movement throughout all sectors. In the service sector, banks have been the leaders for grasping the importance of quality issues. This study attempts to measure customers' satisfaction and personnel's understanding and implementation of service quality in a commercial bank. The study innovates with respect to former studies...
Bradbury-Jones, Caroline; Clark, Maria; Taylor, Julie
The aim of this study was to report the findings of a qualitative case study that investigated abused women's experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care. Domestic violence and abuse is a significant public health issue globally but it is a hidden problem that is under-reported. In the UK, Identification and Referral to Improve Safety is a primary care-based intervention that has been found to increase referral rates of abused women to support and safety services. This paper reports on the findings of an evaluation study of two sites in England. Qualitative study with a case study design. In line with case study design, the entire evaluation study employed multiple data collection methods. We report on the qualitative interviews with women referred through the programme. The aim was to elicit their experiences of the three aspects of the intervention: identification; referral; safety. Data collection took place March 2016. Ten women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health. Nurses have an important role to play in identifying domestic violence and abuse and in referral and safety planning. As part of a portfolio of domestic violence and abuse interventions, those that empower women to take control of their safety (such as Identification and Referral to Improve Safety) are important. © 2017 John Wiley & Sons Ltd.
enhancing suicide-related coping strategies; and (3) increasing acceptability and initiation of appropriate mental health and substance use treatments . This...outpatient mental health or substance abuse treatment appointment within 30 days post the index ED visit. If the safety plan intervention is...months of modifications we received a completed and approved DTM on July 22, 2013. 13. Ft. Belvoir Recruitment Site Update: Fort
Fagan, Johan J.; Jacobs, Marian
Background: Burden of disease (BOD) is greatest in resource-starved regions such as Africa. Even though hearing disability ranks third on the list of non-fatal disabling conditions in low- and middle-income countries, ear, nose, and throat (ENT) disorders are not specifically coded for within the framework governing global BOD estimates, and in discussions about health challenges, non-communicable diseases receive scant attention. Implementing cost-effective interventions to address condition...
Pinto, Meliane Melina
Full Text Available Introduction: The earlier the diagnosis and the intervention from the hearing impairment less will be the impact for the development of cognitive abilities, hearing and of speech from the child. Objective: Characterize the age in the diagnosis and the beginning of intervention of the hearing loss and the accompaniment of the assisted children in a public Brazillian hearing health service - Espaço Reouvir from the Clinicas Hospital from the Medical School from the University of São Paulo. Method: Retrospective study with information from 166 medical records from children regarding the: gender; etiology, type, degree and laterality of the hearing impairment; age in the diagnosis and adaptation of the Hearing aids (HA and accompaniment in the service. Results: The sample was composed by 56% men and 44% women. The prevailing etiology was from multifactorial origin. The hearing loss from the neurosensory type occurred in 88,6% of the cases. The degree of moderate hearing loss was the most frequent (30,7%, symmetry in both ears was found in 69,9% of the cases and unilateral hearing loss in 2,4%. The average age in the diagnosis was of 5,46 years and in the intervention was of 6,86 years. A total of 96,98% of children had already completed the process of adaptation and 78,32% still remained in the accompaniment. Conclusion: The program Reouvir-HCFMUSP still receives children, both for diagnosis and or intervention in a late manner. However, still is possible the realization of the accompaniment of a significant number of users of the hearing aids, enabling a process of adaptation more effective.
Adkins, Elizabeth C; Zalta, Alyson K; Boley, Randy A; Glover, Angela; Karnik, Niranjan S; Schueller, Stephen M
Homelessness has serious consequences for youth that heighten the need for mental health services; however, these individuals face significant barriers to access. New models of intervention delivery are required to improve the dissemination of mental health interventions that tailor these services to the unique challenges faced by homeless youth. The purpose of this study was to better understand homeless youths' use of technology, mental health experiences and needs, and willingness to engage with technology-supported mental health interventions to help guide the development of future youth-facing technology-supported interventions. Five focus groups were conducted with 24 homeless youth (62.5% female) in an urban shelter. Youth were 18- to 20-years-old with current periods of homelessness ranging from 6 days to 4 years. Transcripts of these focus groups were coded to identify themes. Homeless youth reported using mobile phones frequently for communication, music, and social media. They indicated a lack of trust and a history of poor relationships with mental health providers despite recognizing the need for general support as well as help for specific mental health problems. Although initial feelings toward technology that share information with a provider were mixed, they reported an acceptance of tracking and sharing information under certain circumstances. Based on these results, we provide recommendations for the development of mental health interventions for this population focusing on technology-based treatment options. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Morita, Tatsuya; Miyashita, Mitsunori; Yamagishi, Akemi; Akiyama, Miki; Akizuki, Nobuya; Hirai, Kei; Imura, Chizuru; Kato, Masashi; Kizawa, Yoshiyuki; Shirahige, Yutaka; Yamaguchi, Takuhiro; Eguchi, Kenji
Improvement of palliative care is an important public health issue, but knowledge about how to deliver palliative care throughout a region remains inadequate. We used surveys and in-depth interviews to assess changes in the quality of palliative care after regional interventions and to gain insights for improvement of palliative care at a regional level. In this mixed-methods study, a comprehensive programme of interventions for regional palliative care for patients with cancer was implemented from April 1, 2008, to March 31, 2011 in Tsuruoka, Kashiwa, Hamamatsu, and Nagasaki in Japan. Interventions included education, specialist support, and networking. We surveyed patients, bereaved family members, physicians, and nurses before and after the interventions were introduced. We also did qualitative interviews with health-care professionals after the interventions were introduced. Primary endpoints were numbers of home deaths, coverage of specialist services, and patient-reported and family-reported qualities of care. This trial is registered with UMIN Clinical Trial Registry, Japan (UMIN000001274). 859 patients, 1110 bereaved family members, 911 physicians, and 2378 nurses provided analysable preintervention surveys; 857 patients, 1137 bereaved family members, 706 physicians, and 2236 nurses provided analysable postintervention surveys. Proportions of home deaths increased significantly, from 348 of 5147 (6.76%) before the intervention programme to 581 of 5546 (10.48%) after the intervention programme (pnurse-reported difficulties decreased significantly after the introduction of the interventions. Qualitative interviews showed improved communication and cooperation between health-care professionals because of greater opportunities for interactions at various levels. A regional programme of interventions could improve the quality of palliative care. Improvement of communication between health-care professionals is key to improvement of services. Third Term
Fenwick, Jennifer; Gamble, Jenny; Creedy, Debra K; Buist, Anne; Turkstra, Erika; Sneddon, Anne; Scuffham, Paul A; Ryding, Elsa L; Jarrett, Vivian; Toohill, Jocelyn
Childbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body's ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women's childbirth fear, support normal birth, and diminish the possibility of a negative birth experience. Pregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4-6 weeks after birth. This study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women's childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes. Australian New Zealand Controlled Trials Registry ACTRN12612000526875.
Lord, Laura; Clark-Carter, David; Grove, Amy
A systematic review was conducted in order to explore the effectiveness of communication-skills training interventions in end-of-life care with noncancer acute-based healthcare staff. Articles were included if they (1) focused on communication-skills training in end-of-life/palliative care for noncancer acute-based staff and (2) reported an outcome related to behavior change with regard to communication. Sixteen online databases were searched, which resulted in 4,038 potential articles. Screening of titles left 393 articles that met the inclusion criteria. Abstracts (n = 346) and full-text articles (n = 47) were reviewed, leaving 10 papers that met the criteria for our review. All articles explored the effect of communication-skills training on aspects of staff behavior; one study measured the effect on self-efficacy, another explored the impact on knowledge and competence, and another measured comfort levels in discussing the end of life with patients/families. Seven studies measured a number of outcomes, including confidence, attitude, preparedness, stress, and communication skills. Few studies have focused on end-of-life communication-skills training in noncancer acute-based services. Those that do have report positive effects on staff behavior with regard to communication about the end of life with patients and families. The studies varied in terms of the population studied and the health services involved, and they scored only moderately or weakly on quality. It is a challenge to draw a definite conclusion about the effectiveness of training interventions in end-of-life communication because of this. However, the findings from our review demonstrate the potential effectiveness of a range of training interventions with healthcare professionals on confidence, attitude, self-efficacy, and communication skills. Further research is needed to fully explore the effectiveness of existing training interventions in this population, and evidence using objective measures
Azh, Nezal; Nahidi, Fatemeh; Ozgoli, Giti; Ardalan, Gelayol
Providing health services for adolescents requires exploration of hidden factors from the perspective of adolescents, providers, and key individuals. Understanding the process of providing health services from adolescents point of view will help receiving and continuation of services. Although many studies have been conducted in Iran on adolescents health needs, few studies have dealt with provision of these services to adolescents. The present study aimed to explain the adolescents and key informants' perception of healthcare provision. The present qualitative study was conducted according to grounded theory. Data were collected using deep semi-structured individual interviews and group discussion. Participants were selected through purposive sampling followed by theoretical sampling. Participants in present study were 65 adolescents, nine youths (19-24-year-old), and 19 parents and key people involved in providing health services. Adolescents and their parents were selected from different parts of Tehran. Data collection continued until data saturation, and was analysed using Corbin-Strauss (2008) method. Issues relating to adolescents perception of the process of providing services included health concerns, society's inappropriate behaviours, and weakness of the health services system in responding to adolescents needs, which as underlying factors contributed to adolescents confusion in receiving services and their proper coping with puberty. Due to lack of education on how to manage puberty by parents, schools, society, and the health system, participating adolescents from Tehran were confused about receiving information and unable to manage puberty problems. Solving this problem requires continuity of services and interaction of family, school and community.
Jones, Sean; Bremer, Emily; Lloyd, Meghann
Families of children with autism spectrum disorder (ASD) often experience high levels of stress; it is important to investigate the family quality of life (FQOL) to understand how to serve the entire family, not just the child. The purpose of this investigation was to determine: (a) how families with a child with ASD view their overall FQOL and (b) what aspects of everyday life have the greatest influence on the FQOL? A survey designed to asses FQOL was mailed to all families (n = 454) of children with ASD (0-18 years) waiting for government-funded services. Results from 151 surveys were examined (31 % response rate). Descriptive on all variables, ordinal logistic regression, and t tests were used to analyze the data. The most influential factors on FQOL were whether the child with ASD had a major health concern, whether the family's needs were met by disability-related services, and whether there were opportunities to engage in leisure and recreation activities. Families on waitlists experience challenges in FQOL influenced by the health of the family members; this is implicitly important for service agencies and providers. Future research should continue to explore how access to disability-related services impacts FQOL; and how these associations may be moderated by contextual factors such as socioeconomic status, health of child and family members, access and engagement in recreation, and severity of the child's needs.
Full Text Available Oncology is a highly researched therapeutic area with an ever expanding armamentarium of drugs entering the market. It is unique in how the heterogeneity of tumor, patient and treatment factors is critical in determining outcomes of interventions. When it comes to decision making in the clinic, the practicing physician often seeks answers in populations with obvious deviations from the ideal selected populations included in the pivotal phase III randomized controlled trials (RCTs. While the randomized nature of the RCT ensures its high internal validity by removing bias, their ′controlled′ nature casts a doubt on their generalizability to the real world population. It is for this reason that trials done in a naturalistic setting post the marketing authorization of a drug are increasingly required. This article discusses the importance of non interventional drug studies in oncology as an important tool in testing the external validity of controlled trial results and its value in generation of new hypothesis. It also discusses the limitations of such studies while outlining the steps in their effective conduct.
Mishra, Divya; Vora, Jesal
Oncology is a highly researched therapeutic area with an ever expanding armamentarium of drugs entering the market. It is unique in how the heterogeneity of tumor, patient and treatment factors is critical in determining outcomes of interventions. When it comes to decision making in the clinic, the practicing physician often seeks answers in populations with obvious deviations from the ideal selected populations included in the pivotal phase III randomized controlled trials (RCTs). While the randomized nature of the RCT ensures its high internal validity by removing bias, their 'controlled' nature casts a doubt on their generalizability to the real world population. It is for this reason that trials done in a naturalistic setting post the marketing authorization of a drug are increasingly required. This article discusses the importance of non interventional drug studies in oncology as an important tool in testing the external validity of controlled trial results and its value in generation of new hypothesis. It also discusses the limitations of such studies while outlining the steps in their effective conduct.
Asha S George; Casey Branchini; Anayda Portela
... to increase use of maternity care services. Using inclusion and exclusion criteria defined in a peer-reviewed protocol, we searched published and grey literature from one database of studies on maternal health, two search engines, an internet...
Fancourt, Daisy; Perkins, Rosie; Ascenso, Sara; Carvalho, Livia A; Steptoe, Andrew; Williamon, Aaron
.... This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group...
Deborah J. Chavez; Joanne F. Tynon
This study is the second in a series of studies to evaluate perceptions of USDA Forest Service law enforcement personnel of the roles, responsibilities, and issues entailed in their jobs. An e-mail survey was administered to the nine Forest Service special agents in charge (SACs) across the United States. All nine completed and returned the survey. Communication with...
Background Access and equity in children’s therapy services may be improved by directing clinicians’ use of resources toward specific goals that are important to patients. A practice-change intervention (titled ‘Good Goals’) was designed to achieve this. This study investigated uptake, adoption, and possible effects of that intervention in children’s occupational therapy services. Methods Mixed methods case studies (n = 3 services, including 46 therapists and 558 children) were conducted. The intervention was delivered over 25 weeks through face-to-face training, team workbooks, and ‘tools for change’. Data were collected before, during, and after the intervention on a range of factors using interviews, a focus group, case note analysis, routine data, document analysis, and researchers’ observations. Results Factors related to uptake and adoptions were: mode of intervention delivery, competing demands on therapists’ time, and leadership by service manager. Service managers and therapists reported that the intervention: helped therapists establish a shared rationale for clinical decisions; increased clarity in service provision; and improved interactions with families and schools. During the study period, therapists’ behaviours changed: identifying goals, odds ratio 2.4 (95% CI 1.5 to 3.8); agreeing goals, 3.5 (2.4 to 5.1); evaluating progress, 2.0 (1.1 to 3.5). Children’s LoT decreased by two months [95% CI −8 to +4 months] across the services. Cost per therapist trained ranged from £1,003 to £1,277, depending upon service size and therapists’ salary bands. Conclusions Good Goals is a promising quality improvement intervention that can be delivered and adopted in practice and may have benefits. Further research is required to evaluate its: (i) impact on patient outcomes, effectiveness, cost-effectiveness, and (ii) transferability to other clinical contexts. PMID:22898191
Kolehmainen, Niina; MacLennan, Graeme; Ternent, Laura; Duncan, Edward A S; Duncan, Eilidh M; Ryan, Stephen B; McKee, Lorna; Francis, Jill J
Access and equity in children's therapy services may be improved by directing clinicians' use of resources toward specific goals that are important to patients. A practice-change intervention (titled 'Good Goals') was designed to achieve this. This study investigated uptake, adoption, and possible effects of that intervention in children's occupational therapy services. Mixed methods case studies (n = 3 services, including 46 therapists and 558 children) were conducted. The intervention was delivered over 25 weeks through face-to-face training, team workbooks, and 'tools for change'. Data were collected before, during, and after the intervention on a range of factors using interviews, a focus group, case note analysis, routine data, document analysis, and researchers' observations. Factors related to uptake and adoptions were: mode of intervention delivery, competing demands on therapists' time, and leadership by service manager. Service managers and therapists reported that the intervention: helped therapists establish a shared rationale for clinical decisions; increased clarity in service provision; and improved interactions with families and schools. During the study period, therapists' behaviours changed: identifying goals, odds ratio 2.4 (95% CI 1.5 to 3.8); agreeing goals, 3.5 (2.4 to 5.1); evaluating progress, 2.0 (1.1 to 3.5). Children's LoT decreased by two months [95% CI -8 to +4 months] across the services. Cost per therapist trained ranged from £1,003 to £1,277, depending upon service size and therapists' salary bands. Good Goals is a promising quality improvement intervention that can be delivered and adopted in practice and may have benefits. Further research is required to evaluate its: (i) impact on patient outcomes, effectiveness, cost-effectiveness, and (ii) transferability to other clinical contexts.
Najafi, Seyedvahid; Saati, Saber; Tavana, Madjid
Service quality is often conceptualized as the comparison between service expectations and the actual performance perceptions. It enhances customer satisfaction, decreases customer defection, and promotes customer loyalty. Substantial literature has examined the concept of service quality, its dimensions, and measurement methods. We introduce the perceived service quality index (PSQI) as a single measure for evaluating the multiple-item service quality construct based on the SERVQUAL model. A slack-based measure (SBM) of efficiency with constant inputs is used to calculate the PSQI. In addition, a non-linear programming model based on the SBM is proposed to delineate an improvement guideline and improve service quality. An empirical study is conducted to assess the applicability of the method proposed in this study. A large number of studies have used DEA as a benchmarking tool to measure service quality. These models do not propose a coherent performance evaluation construct and consequently fail to deliver improvement guidelines for improving service quality. The DEA models proposed in this study are designed to evaluate and improve service quality within a comprehensive framework and without any dependency on external data.
Full Text Available The main purpose of this paper is to estimate farmers’ preferences and their willingness to pay (WTP for ecosystem services derived from four agricultural water management (AWM and resource recovery and reuse (RRR intervention options in Burkina Faso, using a choice experiment (CE. These include; small water infrastructure, drip irrigation, recovery of organic matter from waste, and treated wastewater. The design decisions relating to attribute selection, the level of attributes, alternatives and choice tasks were guided by literature, field visits, focus group discussions, expert input and an iterative process of the STATA software to generate an orthogonal main-effects CE design. The data used was generated from a random sample of 300 farm households in the Dano and Ouagadougou municipalities in Burkina Faso. Results from conditional logit, latent class logit and mixt logit models show that farmers have positive and significant preferences for drip irrigation, treated wastewater, and organic matter. However, they are WTP on average more for drip irrigation and organic matter for agricultural sustainability. In line with economic theory, the cost of an intervention reduces demand for a given intervention. These findings can provide policy makers with evidence for agricultural policy design to build farmers’ resilience in the Sahel.
Hetrick, Sarah E; O'Connor, Denise A; Stavely, Heather; Hughes, Frank; Pennell, Kerryn; Killackey, Eoin; McGorry, Patrick D
Our aim was to develop an implementation guide that was informed by an analysis of context-specific barriers and enablers, behaviour change theory, as well as evidence about the effects of implementation interventions, for the establishment and scaling up of an early intervention model for psychosis (called Early Psychosis Prevention and Intervention Centre (EPPIC)). We used a systematic approach involving four steps. First, the target behaviours of the EPPIC model for implementation were specified. Second, a consultation was undertaken to explore the barriers and enablers to undertaking these priority minimum standard clinical behaviours. Third, an implementation strategy that included a range of behaviour change techniques tailored to address the identified barriers was developed. Finally, a tool to assess whether those implementing the EPPIC model maintained fidelity to the implementation strategy was designed. We identified a range of barriers that could act to dilute the core components of the EPPIC model and compromise its implementation. An implementation strategy using theory and evidence-based strategies for behaviour change was designed to address these barriers. The process we used in the development of the implementation strategy provided a unique opportunity to consider the essential areas to cover, how to make information easily understandable and accessible while noting the complexity of issues involved in not only implementation, but also the scaling up of the EPPIC model for services. © 2017 John Wiley & Sons Australia, Ltd.
Garbutt Jane M
Full Text Available Abstract Background Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice. Methods and design This paper describes the protocol for a randomized controlled trial (RCT to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1 effective use of controller medications, 2 effective use of rescue medications and 3 monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview. The primary outcomes were the mean change in 1 the child's asthma control score, 2 the parent's quality of life score, and 3 the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications
In clinical work, our main task as music therapists is to make interventions: we give our clients guidance, encouragement, and support; we offer interpretations; we play with and for them. Most of the interventions are either musical or verbal. As a music therapy clinician, supervisor, and educator, I wanted to explore the following questions: (a) How do music therapists define musical and verbal interventions? (b) When does a music therapist intervene musically and when does the therapist intervene verbally? (c) When and why do music therapists suggest to their clients exploring an issue musically or verbally? (d) Do musical and verbal interventions serve the same purpose or different purposes? (d) How is the decision about the type of intervention made? and, (e) is there a difference between the power and meaning of musical interventions versus verbal interventions for both the therapist and the client?
Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte
essential, alongside improved, accessible mental health care and livelihood interventions. As Ethiopia increases access to mental health care, a fundamental barrier to service user involvement is beginning to be addressed. Our study identified further barriers that need to be tackled, including a supportive political climate, and receptiveness amongst stakeholders. The findings will inform the development of a model of service user involvement, which will be piloted and evaluated.
McLeod, Hugh; Blissett, Deirdre; Wyatt, Steven; Mohammed, Mohammed A
Payment incentives are known to influence healthcare but little is known about the impact of paying directly for achieved outcomes. In England, novel purchasing (commissioning) of National Health Service (NHS) stop smoking services, which paid providers for quits achieved whilst encouraging new market entrants, was implemented in eight localities (primary care trusts (PCTs)) in April 2010. This study examines the impact of the novel commissioning on these services. Accredited providers were paid standard tariffs for each smoker who was supported to quit for four and 12 weeks. A cluster-controlled study design was used with the eight intervention PCTs (representing 2,138,947 adult population) matched with a control group of all other (n=64) PCTs with similar demographics which did not implement the novel commissioning arrangements. The primary outcome measure was changes in quits at four weeks between April 2009 and March 2013. A secondary outcome measure was the number of new market entrants within the group of the largest two providers at PCT-level. The number of four-week quits per 1,000 adult population increased per year on average by 9.6% in the intervention PCTs compared to a decrease of 1.1% in the control PCTs (incident rate ratio 1∙108, psmoking services across the eight intervention PCTs in 2011/12, and 84% of the four-week quits were accounted for by the largest two providers at PCT-level. Three of these 10 providers were new market entrants. To the extent that the intervention incentivized providers to overstate quits in order to increase income, caution is appropriate when considering the findings. Novel commissioning to incentivize achievement of specific clinical outcomes and attract new service providers can increase the effectiveness and supply of NHS stop smoking services.
McLeod, Hugh; Blissett, Deirdre; Wyatt, Steven; Mohammed, Mohammed A
Background Payment incentives are known to influence healthcare but little is known about the impact of paying directly for achieved outcomes. In England, novel purchasing (commissioning) of National Health Service (NHS) stop smoking services, which paid providers for quits achieved whilst encouraging new market entrants, was implemented in eight localities (primary care trusts (PCTs)) in April 2010. This study examines the impact of the novel commissioning on these services. Methods Accredited providers were paid standard tariffs for each smoker who was supported to quit for four and 12 weeks. A cluster-controlled study design was used with the eight intervention PCTs (representing 2,138,947 adult population) matched with a control group of all other (n=64) PCTs with similar demographics which did not implement the novel commissioning arrangements. The primary outcome measure was changes in quits at four weeks between April 2009 and March 2013. A secondary outcome measure was the number of new market entrants within the group of the largest two providers at PCT-level. Results The number of four-week quits per 1,000 adult population increased per year on average by 9.6% in the intervention PCTs compared to a decrease of 1.1% in the control PCTs (incident rate ratio 1∙108, psmoking services across the eight intervention PCTs in 2011/12, and 84% of the four-week quits were accounted for by the largest two providers at PCT-level. Three of these 10 providers were new market entrants. To the extent that the intervention incentivized providers to overstate quits in order to increase income, caution is appropriate when considering the findings. Conclusions Novel commissioning to incentivize achievement of specific clinical outcomes and attract new service providers can increase the effectiveness and supply of NHS stop smoking services. PMID:25875959
McGill, Elizabeth; Marks, Dalya; Sumpter, Colin; Egan, Matt
Increasingly, English local authorities have encouraged the implementation of an intervention called 'Reducing the Strength' (RtS) whereby off-licences voluntarily stop selling inexpensive 'super-strength' (≥6.5% alcohol by volume (ABV)) beers and ciders. We conceptualised RtS as an event within a complex system in order to identify pathways by which the intervention may lead to intended and unintended consequences. A qualitative study including a focus group and semistructured interviews. An inner-London local authority characterised by a high degree of residential mobility, high levels of social inequality and a large homeless population. Intervention piloted in three areas known for street drinking with a high alcohol outlet density. Alcohol service professionals, homeless hostel employees, street-based services managers and hostel dwelling homeless alcohol consumers (n=30). Participants describe a range of potential substitution behaviours to circumvent alcohol availability restrictions including consuming different drinks, finding alternative shops, using drugs or committing crimes to purchase more expensive drinks. Service providers suggested the intervention delivered in this local authority missed opportunities to encourage engagement between the council, alcohol services, homeless hostels and off-licence stores. Some participants believed small-scale interventions such as RtS may facilitate new forms of engagement between public and private sector interests and contribute to long-term cultural changes around drinking, although they may also entrench the view that 'problem drinking' only occurs in certain population groups. RtS may have limited individual-level health impacts if the target populations remain willing and able to consume alternative means of intoxication as a substitute for super-strength products. However, RtS may also lead to wider system changes not directly related to the consumption of super-strengths and their assumed harms. Published
Østergaard Christensen, T; Vesterager, Lone; Krarup, G
measure functional capacity. At the post-training assessment, the intervention group had improved significantly on Rosenberg Self-Esteem Scale (Cohen's d=0.54, P=0.01), Positive and Negative Symptoms Scale (PANSS), General Psychopathology Scale (Cohen's d=0.51, P=0.05) and the verbal learning domain...... (Cohen's d=0.44, P=0.04), while improvement on the composite score was marginally significant (Cohen's d=0.34, P=0.05). CONCLUSION: In accordance with other cognitive remediation programmes, this programme demonstrates some immediate and long-term effect on cognitive functioning, symptoms and self-esteem....
Cheng, Sheung-Tak; Chan, Ka Long; Lam, Rosanna W L; Mok, Monique H T; Chen, Phoon Ping; Chow, Yu Fat; Chung, Joanne W Y; Law, Alexander C B; Lee, Jenny S W; Leung, Edward M F; Tam, Cindy W C
Studies have shown that physical interventions and psychological methods based on the cognitive behavioral approach are efficacious in alleviating pain and that combining both tends to yield more benefits than either intervention alone. In view of the aging population with chronic pain and the lack of evidence-based pain management programs locally, we developed a multicomponent intervention incorporating physical exercise and cognitive behavioral techniques and examined its long-term effects against treatment as usual (i.e., pain education) in older adults with chronic musculoskeletal pain in Hong Kong. We are conducting a double-blind, cluster-randomized controlled trial. A sample of 160 participants aged ≥ 60 years will be recruited from social centers or outpatient clinics and will be randomized on the basis of center/clinic to either the multicomponent intervention or the pain education program. Both interventions consist of ten weekly sessions of 90 minutes each. The primary outcome is pain intensity, and the secondary outcomes include pain interference, pain persistence, pain self-efficacy, pain coping, pain catastrophizing cognitions, health-related quality of life, depressive symptoms, and hip and knee muscle strength. All outcome measures will be collected at baseline, postintervention, and at 3 and 6 months follow-up. Intention-to-treat analysis will be performed using mixed-effects regression to see whether the multicomponent intervention alleviates pain intensity and associated outcomes over and above the effects of pain education (i.e., a treatment × time intervention effect). Because the activities included in the multicomponent intervention were carefully selected for ready implementation by allied health professionals in general, the results of this study, if positive, will make available an efficacious, nonpharmacological pain management program that can be widely adopted in clinical and social service settings and will hence improve older
Makaen, Johnson; Omena, Mathew
The reemergence of tuberculosis, including multidrug-resistant strains, in Papua New Guinea highlights the never ending nature of the antituberculosis (anti-TB) campaign in that country and warrants the need for constant vigilance against the condition. Through surveillance, early detection, and management, the spread and incidence of TB can be kept in check. To maintain successful TB control programs, the government and partners committed to this campaign need to overhaul essential aspects of laboratory services. Clinical laboratories play a critical role in diagnostics; their functions cannot be substituted nor relegated. It is time to end neglect of these services in Papua New Guinea and to arm the laboratories in that country with full financial and logistical support so that they can lead the campaign against TB. Copyright© by the American Society for Clinical Pathology (ASCP).
Sanders, Matthew R; Prinz, Ronald J; Shapiro, Cheri J
Multidisciplinary service providers (N = 611) who underwent training in the Triple P-Positive Parenting Program participated in a structured interview 6 months following training to determine their level of post-training program use and to identify any facilitators and barriers to program use. Findings revealed that practitioners who had received training in Group Triple P, received positive client feedback, had experienced only minor barriers to implementation, and had consulted with other Triple P practitioners following training were more likely to become high users of the program. Practitioners were less likely to use the program when they had lower levels of confidence in delivering Triple P and in consulting with parents in general, had difficulties in incorporating Triple P into their work, and where there was low workplace support. These findings highlight the importance of considering the broader post training work environment of service providers as a determinant of subsequent program use.
Full Text Available Jailed women are four-five times more likely to have had cervical cancer compared to women without criminal justice histories. Previous research has shown that an important contributor to cervical cancer risk, and perhaps lack of follow-up, is incarcerated women's low health literacy about broader reproductive health issues. Little work has been done to address this disparity. Thus, the objective of this study was to test the effectiveness of an intervention to improve incarcerated women's cervical health literacy and ultimately address cervical cancer disparities. Using a waitlist control design, we compared changes in cervical health literacy (knowledge, beliefs, self-efficacy, and confidence for screening and follow-up among 188 incarcerated women who completed a 10-hour intervention between 2014 and 2016 in three Kansas City jails. We used bivariate tests and multivariate analyses that controlled for baseline cervical health literacy level and key covariates. Women in the intervention group showed significant gains in seven out of eight cervical health literacy domains (all p < 0.01, whereas the control group only improved in one domain (p < 0.01. When controlling for covariates, the intervention group had less barriers, perceptions of seriousness, susceptibility to disease, and increased self-efficacy for cervical health screening and follow-up, compared to the control group (all p < 0.05. A brief intervention is an effective way to improve jailed women's cervical health literacy, but should be provided alongside systemic efforts that expand access to correctional preventive health services, including the human papillomavirus vaccine, community-based cancer screenings, and health insurance after women leave jails and transition back to communities.
Smith, Michael J; Bayehi, Antoinette Derjani
This paper examines whether improving physical ergonomics working conditions affects worker productivity in a call centre with computer-intensive work. A field study was conducted at a catalogue retail service organization to explore the impact of ergonomics improvements on worker production. There were three levels of ergonomics interventions, each adding incrementally to the previous one. The first level was ergonomics training for all computer users accompanied by workstation ergonomics analysis leading to specific customized adjustments to better fit each worker (Group C). The second level added specific workstation accessories to improve the worker fit if the ergonomics analysis indicated a need for them (Group B). The third level met Group B requirements plus an improved chair (Group A). Productivity data was gathered from 72 volunteer participants who received ergonomics improvements to their workstations and 370 control subjects working in the same departments. Daily company records of production outputs for each worker were taken before ergonomics intervention (baseline) and 12 months after ergonomics intervention. Productivity improvement from baseline to 12 months post-intervention was examined across all ergonomics conditions combined, and also compared to the control group. The findings showed that worker performance increased for 50% of the ergonomics improvement participants and decreased for 50%. Overall, there was a 4.87% output increase for the ergonomics improvement group as compared to a 3.46% output decrease for the control group. The level of productivity increase varied by the type of the ergonomics improvements with Group C showing the best improvement (9.43%). Even though the average production improved, caution must be used in interpreting the findings since the ergonomics interventions were not successful for one-half of the participants.
Zha, Z.; Zhang, L.; Wang, C.; Jiang, J.; Huang, W.
The construction of platform for geoinformation common services was completed or on going in in most provinces and cities in these years in China, and the platforms plays an important role in the economic and social activities. Geoinfromation and geoinfromation based services are the key issues in the platform. The standards on geoinormation common services play as bridges among the users, systems and designers of the platform. The standard architecture for geoinformation common services is the guideline for designing and using the standard system in which the standards integrated to each other to promote the development, sharing and services of geoinformation resources. To establish the standard architecture for geoinformation common services is one of the tasks of "Study on important standards for geonformation common services and management of public facilities in city". The scope of the standard architecture is defined, such as data or information model, interoperability interface or service, information management. Some Research work on the status of international standards of geoinormation common services in organization and countries, like ISO/TC 211, OGC and other countries or unions like USA, EU, Japan have done. Some principles are set up to evaluate the standard, such as availability, suitability and extensible ability. Then the development requirement and practical situation are analyzed, and a framework of the standard architecture for geoinformation common services are proposed. Finally, a summary and prospects of the geoinformation standards are made.
This paper examines the purpose, role and function of information and information management within health care today. It is set within the context of a specialist forensic learning disability setting. Changes in politics, government legislation and reforms of the National Health Service (NHS) have created a need to equip managers with the necessary tools and skills to be able to lead and manage effectively. As such there has been a great emphasis upon specialist training, such as the government-driven Leading an Empowered Organisation courses, for nurse managers and nurses with leadership potential. Yet with the drive to generate a new wave culture within the NHS of inspirational leaders, are we still overlooking a critical and key area which is fundamental in achieving and delivering cost effective, quality health care--the area of information management within health care today? The processes presented in this paper are structured through a strategic nursing management and leadership performance implementation model, the Clinical Nursing Leadership Learning and Action Process (CLINLAP) model, which facilitates work-based learning and capability development in the reality of everyday clinical activities. Through the model, the emphasis is to make clinical goals specific, roles explicit, processes clear and encourage these activities to be carried out within an environment of open relationships. The use of CLINLAP model assisted as a management and leadership technology to manage change in the workplace so as to improve services to patients in Yelday Lodge. Structured management and leadership interventions led to observable positive change in information management on Yelday Lodge. The conclusion is that sustained quality information could be embedded in nursing practice at Yelday Lodge or elsewhere by evaluating and discussing the different information management approaches within the practice area through the use of structured management and leadership
Kidd, Sean A; Madan, Athena; Rallabandi, Susmitha; Cole, Donald C; Muskat, Elisha; Raja, Shoba; Wiljer, David; Aylward, David; McKenzie, Kwame
In the debate in global mental health about the most effective models for developing and scaling interventions, there have been calls for the development of a more robust literature regarding the "non-specific", science of delivery aspects of interventions that are locally, contextually, and culturally relevant. This study describes a rigorous, exploratory, qualitative examination of the key, non-specific intervention strategies of a diverse group of five internationally-recognized organizations addressing mental illness in middle income countries (MICs). A triangulated approach to inquiry was used with semi-structured interviews conducted with service recipients, service providers and leaders, and key community partners (N = 159). The interview focus was upon processes of implementation and operation. A grounded theory-informed analysis revealed cross cutting themes of: a holistic conceptualization of mental health problems, an intensive application of principles of leverage and creating the social, cultural, and policy "space" within which interventions could be applied and resourced. These findings aligned with key aspects of systems dynamic theory suggesting that it might be a helpful framework in future studies of mental health service implementation in MICs.
Sean A Kidd
Full Text Available In the debate in global mental health about the most effective models for developing and scaling interventions, there have been calls for the development of a more robust literature regarding the "non-specific", science of delivery aspects of interventions that are locally, contextually, and culturally relevant. This study describes a rigorous, exploratory, qualitative examination of the key, non-specific intervention strategies of a diverse group of five internationally-recognized organizations addressing mental illness in middle income countries (MICs. A triangulated approach to inquiry was used with semi-structured interviews conducted with service recipients, service providers and leaders, and key community partners (N = 159. The interview focus was upon processes of implementation and operation. A grounded theory-informed analysis revealed cross cutting themes of: a holistic conceptualization of mental health problems, an intensive application of principles of leverage and creating the social, cultural, and policy "space" within which interventions could be applied and resourced. These findings aligned with key aspects of systems dynamic theory suggesting that it might be a helpful framework in future studies of mental health service implementation in MICs.
U.S. Department of Transportation regulations implementing Section 504 of the Rehabilitation Act of 1973, require transit agencies to provide wheelchair accessibility on fixed-route bus service. The study is part of the series which included studies ...
Full Text Available Abstract Background High-quality cancer information resources are available but underutilized by the public. Despite greater awareness of the National Cancer Institute's Cancer Information Service among low-income African Americans and Hispanics compared with Caucasians, actual Cancer Information Service usage is lower than expected, paralleling excess cancer-related morbidity and mortality for these subgroups. The proposed research examines how to connect the Cancer Information Service to low-income African-American and Hispanic women and their health care providers. The study will examine whether targeted physician mailing to women scheduled for colposcopy to follow up an abnormal Pap test can increase calls to the Cancer Information Service, enhance appropriate medical follow-up, and improve satisfaction with provider-patient communication. Methods/Design The study will be conducted in two clinics in ethnically diverse low-income communities in Chicago. During the formative phase, patients and providers will provide input regarding materials planned for use in the experimental phase of the study. The experimental phase will use a two-group prospective randomized controlled trial design. African American and Hispanic women with an abnormal Pap test will be randomized to Usual Care (routine colposcopy reminder letter or Intervention (reminder plus provider recommendation to call the Cancer Information Service and sample questions to ask. Primary outcomes will be: 1 calls to the Cancer Information Service; 2 timely medical follow-up, operationalized by whether the patient keeps her colposcopy appointment within six months of the abnormal Pap; and 3 patient satisfaction with provider-patient communication at follow-up. Discussion The study examines the effectiveness of a feasible, sustainable, and culturally sensitive strategy to increase awareness and use of the Cancer Information Service among an underserved population. The goal of linking a
Cofta-Woerpel, Ludmila; Randhawa, Veenu; McFadden, H Gene; Fought, Angela; Bullard, Emily; Spring, Bonnie
High-quality cancer information resources are available but underutilized by the public. Despite greater awareness of the National Cancer Institute's Cancer Information Service among low-income African Americans and Hispanics compared with Caucasians, actual Cancer Information Service usage is lower than expected, paralleling excess cancer-related morbidity and mortality for these subgroups. The proposed research examines how to connect the Cancer Information Service to low-income African-American and Hispanic women and their health care providers. The study will examine whether targeted physician mailing to women scheduled for colposcopy to follow up an abnormal Pap test can increase calls to the Cancer Information Service, enhance appropriate medical follow-up, and improve satisfaction with provider-patient communication. The study will be conducted in two clinics in ethnically diverse low-income communities in Chicago. During the formative phase, patients and providers will provide input regarding materials planned for use in the experimental phase of the study. The experimental phase will use a two-group prospective randomized controlled trial design. African American and Hispanic women with an abnormal Pap test will be randomized to Usual Care (routine colposcopy reminder letter) or Intervention (reminder plus provider recommendation to call the Cancer Information Service and sample questions to ask). Primary outcomes will be: 1) calls to the Cancer Information Service; 2) timely medical follow-up, operationalized by whether the patient keeps her colposcopy appointment within six months of the abnormal Pap; and 3) patient satisfaction with provider-patient communication at follow-up. The study examines the effectiveness of a feasible, sustainable, and culturally sensitive strategy to increase awareness and use of the Cancer Information Service among an underserved population. The goal of linking a public service (the Cancer Information Service) with real
Wiler, Jennifer L; Ross, Michael A; Ginde, Adit A
The objective was to describe patient and facility characteristics of emergency department (ED) observation services in the United States. The authors analyzed the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS). Characteristics of EDs with observation units (OUs) were compared to those without, and patients with a disposition of ED observation were compared to those with a "short-stay" (observational analysis. An estimated 1,746 U.S. EDs (36%) reported having OUs, of which 56% are administratively managed by ED staff. Fifty-two percent of hospitals with ED-managed OUs are in an urban location, and 89% report ED boarding, compared to 29 and 65% of those that do not have an OU. The admission rate is 38% at those with ED-managed OUs and 15% at those without OUs. Of the 15.1% of all ED patients who are kept in the hospital following an ED visit, one-quarter are kept for either a short-stay admission (1.8%) or an ED observation admission (2.1%). Most (82%) ED observation patients were discharged from the ED. ED observation patients were similar to short-stay admission patients in terms of age (median = 52 years for both, interquartile range = 36 to 70 years), self-pay (12% vs. 10%), ambulance arrival (37% vs. 36%), urgent/emergent triage acuity (77% vs. 74%), use of ≥1 ED medication (64% vs.76%), and the most common primary chief complaints and primary diagnoses. Over one-third of U.S. EDs have an OU. Short-stay admission patients have similar characteristics as ED observation patients and may represent an opportunity for the growth of OUs. © 2011 by the Society for Academic Emergency Medicine.
Karow, A; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Lambert, M
Numerous birth-control studies, epidemiological studies, and observational studies investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use of children, adolescents and young adults is low, even lower than in adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the border of child and adolescent and adult psychiatry. Emerging studies show that these health care structures are effective and efficient. Part 2 of the present review focuses on illness burden including disability and costs, deficits of the present health care system in Germany, and efficacy and efficiency of early intervention services. © Georg Thieme Verlag KG Stuttgart · New York.
Despite the fact that service quality is a critical determinant of website success, studies show that consumers frequently view the service quality delivered through websites as unsatisfactory. This paper outlines a study that investigated the dimensions of website service excellence valued by Irish customers of a small-to-medium enterprise specialising in gifts. The E-S-QUAL measurement instrument was applied to the customers who purchase products online from this retailer, in order to determine their purchasing patterns and the dimensions of e-service quality that they value. The results of this study indicate the effectiveness of the instrument in determining gaps in e-service quality. The findings will be of benefit both to practitioners and researchers seeking to improve their understanding of the factors that contribute towards the creation and maintenance of consumer satisfaction in Irish online transactions.
Sumaedi, Sik; Bakti, Gede Mahatma Yuda; Metasari, Nur
Purpose: This paper aims to identify: university students' perceived service quality dimensions; the dimensions contributing most towards overall students' perceived service quality; and whether there is a difference in perceived quality level of each dimension based on students' year of study and gender in the context of undergraduate students of…
Folkestad, James E.; Senior, Bolivar A.; DeMirana, Michael A.
A "toys for tots" service-learning experience integrated into an industrial technology management course required development and planning using a process planning and costing model and work with a variety of stakeholders including an Even-Start learning center. Challenges include the lack of service-learning precedent in technology studies and…
Deborah J. Chavez; Joanne F. Tynon
This is the third in a series of studies to evaluate perceptions of USDA Forest Service law enforcement personnel of the roles, responsibilities, and issues entailed in their jobs. An e-mail survey was administered to the 79 Forest Service patrol captains and patrol commanders (PCs) across the United States. Seventy completed and returned the questionnaire....
Hooker, Gillian W; Babu, D; Myers, M F; Zierhut, H; McAllister, M
As the demand for evidence to support the value of genetic counseling increases, it is critical that reporting of genetic counseling interventions in research and other types of studies (e.g. process improvement or service evaluation studies) adopt greater rigor. As in other areas of healthcare, the appraisal, synthesis, and translation of research findings into genetic counseling practice are likely to be improved if clear specifications of genetic counseling interventions are reported when studies involving genetic counseling are published. To help improve reporting practices, the National Society of Genetic Counselors (NSGC) convened a task force in 2015 to develop consensus standards for the reporting of genetic counseling interventions. Following review by the NSGC Board of Directors, the NSGC Practice Guidelines Committee and the editorial board of the Journal of Genetic Counseling, 23 items across 8 domains were proposed as standards for the reporting of genetic counseling interventions in the published literature (GCIRS: Genetic Counseling Intervention Reporting Standards). The authors recommend adoption of these standards by authors and journals when reporting studies involving genetic counseling interventions.
Hori, Hikaru; Ikenouchi-Sugita, Atsuko; Yoshimura, Reiji; Nakamura, Jun
The purpose of this study was to evaluate the impact of a 4-week walking intervention on subjective sleep quality. A prospective open-label study. A total of 490 healthy workers were included in the study. The 490 participants were divided into a group of 214 participants with exercise habits (exercising group, EG) and a group of 276 participants without exercise habits (non-EG). A walking intervention with a target of walking 10 000 steps daily for 4 weeks. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was administered twice (before the start and after the end of the study). Overall, the walking intervention improved the participants' PSQI global score, sleep latency (minutes), sleep duration (hours), perceived sleep quality factor and daily disturbance factor. Among the EG participants, the walking intervention significantly improved the PSQI global score and perceived sleep quality. Among the non-EG participants, the walking intervention significantly improved the PSQI global score, sleep latency, sleep duration and perceived sleep quality. A walking intervention might reduce the sleep latency and increase total sleep duration in working persons without exercise habits. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Wilson, Paul M; Farley, Kate; Bickerdike, Liz; Booth, Alison; Chambers, Duncan; Lambert, Mark; Thompson, Carl; Turner, Rhiannon; Watt, Ian S
The Health and Social Care Act mandated research use as a core consideration of health service commissioning arrangements in England. We undertook a controlled before and after study to evaluate whether access to a demand-led evidence briefing service improved the use of research evidence by commissioners compared with less intensive and less targeted alternatives. Nine Clinical Commissioning Groups (CCGs) in the North of England received one of three interventions: (A) access to an evidence briefing service; (B) contact plus an unsolicited push of non-tailored evidence; or (C) unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months using a survey instrument devised to assess an organisations' ability to acquire, assess, adapt and apply research evidence to support decision-making. Documentary and observational evidence of the use of the outputs of the service were sought. Over the course of the study, the service addressed 24 topics raised by participating CCGs. At 12 months, the evidence briefing service was not associated with increases in CCG capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCG relationships with researchers. Regardless of intervention received, participating CCGs indicated that they remained inconsistent in their research-seeking behaviours and in their capacity to acquire research. The informal nature of decision-making processes meant that there was little traceability of the use of evidence. Low baseline and follow-up response rates and missing data limit the reliability of the findings. Access to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear well intentioned but ad hoc users of research. Further research is required on
Graeff-Martins, Ana Soledade; Oswald, Sylvia; Comassetto, Júlia Obst; Kieling, Christian; Gonçalves, Renata Rocha; Rohde, Luis Augusto
School dropout rates are staggeringly high in developing countries, even for elementary school children. This study aims to assess the feasibility and initial efficacy of a package of interventions tailored to reduce school dropout in public schools in an urban city in Brazil. Two public schools with similar high rates of dropout in elementary grades were selected. In one of them, a package of universal preventive interventions was implemented during a school year, including two workshops with teachers, five informative letters to parents, three meetings with parents at school, a telephone helpline at school, and a 1-day cognitive intervention. For children who stayed ten consecutive days out of school without reason, mental health assessment and referral to mental health services in the community were offered. In the second school, no intervention was implemented. After this 1-year intervention, there were significant differences between the two schools in rates of both dropout (P school, 18 (45%) youths returned to school after intervention among the 40 at-risk students. Moderate engagement of school staff was the main logistic problem. Our findings suggest that programs combining universal primary preventive strategies and interventions focused on at-risk students can be implemented and useful in developing countries to reduce school dropout.
Wynd, Andrew HD; Carachi, Robert
Background and Aims Literature on interventions that enable young people with spina bifida and/or hydrocephalus to have smooth transition, into adult healthcare services, stress the need for the process to start early and to include all family members. The study reported here was set to quantify and articulate the experiences of service users who are or due to be going through the transition process in Scotland today. Methods and Results Focus group sessions, in the North of Scotland and in the ‘Central Belt’, captured rich qualitative data. A survey, sent to eligible participants on the Spina Bifida National database, offered complimentary data source. Despite the fact that the number of returned questionnaires was low (n = 20), data analysis identified a number of core recurring themes. These include issues concerning Communications, Respect, Choice and Control. Findings suggest that there is a significant chasm between the political rhetoric and the reality faced by young people with spina bifida moving to adult healthcare services. Conclusion A possible way to facilitate successful transition of young people is using personal healthcare information as the locus for needed change. More research is needed to ascertain whether a ‘Person-Centred Record’, which is set to empower young people on their transition pathway, is an appropriate transition tool. PMID:25358489
Full Text Available Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist intervention in comparison with usual care in depressed patients initiating treatment with antidepressants in primary care.Patients were recruited by general practitioners and randomized to community pharmacist intervention (87 that received an educational intervention and usual care (92. Adherence to antidepressants, clinical symptoms, Quality-Adjusted Life-Years (QALYs, use of healthcare services and productivity losses were measured at baseline, 3 and 6 months.There were no significant differences between groups in costs or effects. From a societal perspective, the incremental cost-effectiveness ratio (ICER for the community pharmacist intervention compared with usual care was €1,866 for extra adherent patient and €9,872 per extra QALY. In terms of remission of depressive symptoms, the usual care dominated the community pharmacist intervention. If willingness to pay (WTP is €30,000 per extra adherent patient, remission of symptoms or QALYs, the probability of the community pharmacist intervention being cost-effective was 0.71, 0.46 and 0.75, respectively (societal perspective. From a healthcare perspective, the probability of the community pharmacist intervention being cost-effective in terms of adherence, QALYs and remission was of 0.71, 0.76 and 0.46, respectively, if WTP is €30,000.A brief community pharmacist intervention addressed to depressed patients initiating antidepressant treatment showed a probability of being cost-effective of 0.71 and 0.75 in terms of improvement of adherence and QALYs, respectively, when compared to usual care. Regular implementation of the community pharmacist intervention is not recommended.ClinicalTrials.gov NCT
Rubio-Valera, Maria; Bosmans, Judith; Fernández, Ana; Peñarrubia-María, Maite; March, Marian; Travé, Pere; Bellón, Juan A.; Serrano-Blanco, Antoni
Background Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist intervention in comparison with usual care in depressed patients initiating treatment with antidepressants in primary care. Methods Patients were recruited by general practitioners and randomized to community pharmacist intervention (87) that received an educational intervention and usual care (92). Adherence to antidepressants, clinical symptoms, Quality-Adjusted Life-Years (QALYs), use of healthcare services and productivity losses were measured at baseline, 3 and 6 months. Results There were no significant differences between groups in costs or effects. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the community pharmacist intervention compared with usual care was €1,866 for extra adherent patient and €9,872 per extra QALY. In terms of remission of depressive symptoms, the usual care dominated the community pharmacist intervention. If willingness to pay (WTP) is €30,000 per extra adherent patient, remission of symptoms or QALYs, the probability of the community pharmacist intervention being cost-effective was 0.71, 0.46 and 0.75, respectively (societal perspective). From a healthcare perspective, the probability of the community pharmacist intervention being cost-effective in terms of adherence, QALYs and remission was of 0.71, 0.76 and 0.46, respectively, if WTP is €30,000. Conclusion A brief community pharmacist intervention addressed to depressed patients initiating antidepressant treatment showed a probability of being cost-effective of 0.71 and 0.75 in terms of improvement of adherence and QALYs, respectively, when compared to usual care. Regular implementation of the community pharmacist intervention is not recommended
Houle, Sherilyn K D; Charrois, Theresa L; Faruquee, Chowdhury F; Tsuyuki, Ross T; Rosenthal, Meagen M
The provision of medication management (MM) services by community pharmacists has not been as widely implemented as expected. The Promoting Action on Research Implementation in Health Services framework proposes that in addition to evidence of benefit and a practice context conducive to change, health professionals benefit from facilitation to support their efforts. However, the impact of facilitation on patient care services in community pharmacy has not been studied. The primary objective of this study was to explore the needs of community pharmacists in improving the provision of MM services to patients, and secondarily to use external facilitation to support pharmacies in increasing the number of MM services provided. Ten community pharmacies in Alberta, Canada were randomized to external task-focused facilitation or usual practice. Facilitators interviewed staff of each intervention pharmacy to determine current workflow and barriers and facilitators to service provision, and collaborated to address these site-specific barriers over 6 months. Barriers identified by all intervention sites related to the impact of MM on dispensing, lengthy documentation, inefficient use of follow-up opportunities to address lower-priority concerns, and inconsistent patient identification. Strategies to address these barriers were generally well received by sites, which noted that facilitation improved staff communication and encouraged reflection on current practices; however, MM counts across both groups decreased over the intervention versus baseline. This decline was likely due to the unanticipated effect of the influenza vaccination season occurring concurrently with the intervention period. External facilitation appears to be a feasible and acceptable method to support community pharmacy provision of MM services. However, as the scope of pharmacists' practice increases, serious consideration of how, and when, these services can be consistently offered must be made. Relevant
Jensen, Olaf Chresten
Introduction Intervention studies in public- and occupational health on chronic non-infectious diseases have been increasingly used. Also in the maritime health area, intervention studies have been done and some are on the way. The intervention methods are most often counselling or education...... to modify the specific risk factors for cardiovascular diseases, diabetes, hypertension, hyperlipidaemia and obesity. The objective here is to present the methodological gold standard for the intervention studies and to discuss how to improve the intervention studies and programs. Material and Methods...... As a starting point the specific features of an ideal randomized occupational health intervention research model is presented. Two large reviews on health intervention studies are presented as an offset to discuss how the health intervention studies and programs can be improved. Results A Cochrane review based...
Full Text Available Richelle C Kosse,1 Marcel L Bouvy,1 Tjalling W de Vries,2 Ad A Kaptein,3 Harm CJ Geers,1 Liset van Dijk,4 Ellen S Koster1 1Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, 2Department of Paediatrics, Medical Center Leeuwarden, Leeuwarden, 3Medical Psychology, Leiden University Medical Center, Leiden, 4NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands Purpose: Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. Intervention: The ADAPT intervention consists of an interactive smartphone application (app connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1 a questionnaire function to rate asthma symptoms and monitor these over time; 2 short movie clips with medication and disease information; 3 a medication reminder; 4 a chat function with peers; and 5 a chat function with the pharmacist. The pharmacist receives data from the patient’s app through the desktop application, which enables the pharmacist to send information and feedback to the patient. Study design: The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient’s self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. Conclusion: This study will provide in
Pryor, Riana R; Casa, Douglas J; Vandermark, Lesley W; Stearns, Rebecca L; Attanasio, Sarah M; Fontaine, Garrett J; Wafer, Alex M
Authors of the most recent study of athletic training (AT) services have suggested that only 42% of secondary schools have access to athletic trainers. However, this study was limited by a small sample size and was conducted more than 10 years ago. To determine current AT services in public secondary schools. Cross-sectional study. Public secondary schools in the United States. A total of 8509 (57%) of 14,951 secondary schools from all 50 states and Washington, DC, responded to the survey. Data on AT services were collected for individual states, National Athletic Trainers' Association districts, and the nation. Of the 8509 schools that responded, 70% (n = 5930) had AT services, including full-time (n = 3145, 37%), part-time (n = 2619, 31%), and per diem (n = 199, 2%) AT services, and 27% (n = 2299) had AT services from a hospital or physical therapy clinic. A total of 4075 of 8509 schools (48%) provided coverage at all sports practices. Eighty-six percent (2,394,284/2,787,595) of athletes had access to AT services. Since the last national survey, access to AT services increased such that 70% of respondent public secondary schools provided athletic trainers at sports games or practices. Approximately one-third of all public secondary schools had full-time athletic trainers. This number must increase further to provide appropriate medical coverage at athletic practices and games for secondary school athletes.
Green, Lisa M; Ratcliffe, Desi; Masters, Kathleen; Story, Lachel
The purpose of this study was to determine whether nurses could use a structured intervention to educate patients with wounds about foods that promote healing and whether this educational intervention could be provided in a cost-effective manner. Cross-sectional survey. The study was conducted at an outpatient wound care center located on a hospital campus in the Southern United States; 3 full-time nurses and 2 nurses employed on part-time status delivered the intervention. A nutrition education intervention was developed through collaborative efforts of a registered dietitian and a nurse. A cross-sectional survey design was used to (1) evaluate nurses' perceptions of the intervention and (2) identify barriers to implementation of the intervention. Direct costs related to materials and nursing time required to deliver the intervention were calculated. Participants indicated they were competent to deliver the structured intervention, and all were willing to continue its use. Survey results indicated that nurses believed the intervention was beneficial to their patients and they indicated that patients were responsive to the intervention. The intervention was found to be low cost ($8.00 per teaching session); no barriers to implementation of the intervention were identified. The results of this exploratory study suggest that a structured nutrition education intervention can be provided by nurses in outpatient wound clinics at low cost. Further study is needed to determine the impact of this intervention on nutritional intake and wound healing.
A psychological intervention for smoking cessation delivered as treatment for smokers with chronic obstructive pulmonary disease: Multiple needs of a complex group and recommendations for novel service development.
Yap, Su Yin; Lunn, Sarah; Pang, Elizabeth; Croft, Carla; Stern, Myra
This pilot study investigated the benefits of adjunctive psychological intervention for smokers accessing standard smoking cessation interventions. Chronic obstructive pulmonary disease (COPD) smokers attending a smoking cessation service were offered up to 12 adjunctive clinical psychology sessions. Baseline data included demographics, smoking history, and disease severity. Outcomes included attendance and quit rate. In all, 59 patients with moderate COPD were referred. Of the 20 patients who attended training sessions, 7 (35%) were relapse prevention referrals and 13 (65%) were current smokers. Of the seven relapse prevention referrals, six (86%) maintained their quit, 2 of 13 (15%) of the current smoker group maintained a 28-day quit and 3 of 13 (23%) of current smokers reduced their tobacco intake. For COPD smokers with a heavy smoking history and multiple past quit attempts, there was insufficient evidence to show that additional psychological intervention leads to higher quit rates. Significant barriers to quitting and complex medical and psychosocial needs were identified in this group, suggesting that the current 'one-size-fits-all' approach to smoking cessation may not be sufficient to meet the needs of such a complex group. © The Author(s) 2015.
Rosell-Murphy, Magdalena; Bonet-Simó, Josep M; Baena, Esther; Prieto, Gemma; Bellerino, Eva; Solé, Francesc; Rubio, Montserrat; Krier, Ilona; Torres, Pascuala; Mimoso, Sonia
Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver.Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life. CONTROLled, multicentre, community intervention trial, with patients and their caregivers randomized to the intervention or control group according to their assigned Primary Health Care Team (PHCT). Primary Health Care network (9 PHCTs). Primary informal caregivers of patients receiving home health care from participating PHCTs. Required sample size is 282 caregivers (141 from PHCTs randomized to the intervention group and 141 from PHCTs randomized to the control group. a) PHCT professionals: standardized training to implement caregivers intervention. b) Caregivers: 1 individualized counselling session, 1 family session, and 4 educational group sessions conducted by participating PHCT professionals; in addition to usual home health care visits, periodic telephone follow-up contact and unlimited telephone support. Caregivers and dependent patients: usual home health care, consisting of bimonthly scheduled visits, follow-up as needed, and additional attention upon request.Data analysisDependent variables: Caregiver burden (short-form Zarit test), caregivers' social support (Medical Outcomes Study), and caregivers' reported quality of life (SF-12)INDEPENDENT VARIABLES: a) Caregiver: sociodemographic data
Full Text Available Congregations and other religious organizations are an important part of the social welfare system in the United States. This article uses data from the 2012 National Congregations Study to describe key features of congregational involvement in social service programs and projects. Most congregations (83%, containing 92% of religious service attendees, engage in some social or human service activities intended to help people outside of their congregation. These programs are primarily oriented to food, health, clothing, and housing provision, with less involvement in some of the more intense and long-term interventions such as drug abuse recovery, prison programs, or immigrant services. The median congregation involved in social services spent $1500 per year directly on these programs, and 17% had a staff member who worked on them at least a quarter of the time. Fewer than 2% of congregations received any government financial support of their social service programs and projects within the past year; only 5% had applied for such funding. The typical, and probably most important, way in which congregations pursue social service activity is by providing small groups of volunteers to engage in well-defined and bounded tasks on a periodic basis, most often in collaboration with other congregations and community organizations.
Bonevski, Billie; Guillaumier, Ashleigh; Shakeshaft, Anthony; Farrell, Michael; Tzelepis, Flora; Walsberger, Scott; D'Este, Catherine; Paul, Chris; Dunlop, Adrian; Searles, Andrew; Kelly, Peter; Fry, Rae; Stirling, Robert; Fowlie, Carrie; Skelton, Eliza
The provision of smoking cessation support in Australian drug and alcohol treatment services is sub-optimal. This study examines the cost-effectiveness of an organisational change intervention to reduce smoking amongst clients attending drug and alcohol treatment services. A cluster-randomised controlled trial will be conducted with drug and alcohol treatment centres as the unit of randomisation. Biochemically verified (carbon monoxide by breath analysis) client 7-day-point prevalence of smoking cessation at 6 weeks will be the primary outcome measure. The study will be conducted in 33 drug and alcohol treatment services in four mainland states and territories of Australia: New South Wales, Australian Capital Territory, Queensland, and South Australia. Eligible services are those with ongoing client contact and that include pharmacotherapy services, withdrawal management services, residential rehabilitation, counselling services, and case management services. Eligible clients are those aged over 16 years who are attending their first of a number of expected visits, are self-reported current smokers, proficient in the English language, and do not have severe untreated mental illness as identified by the service staff. Control services will continue to provide usual care to the clients. Intervention group services will receive an organisational change intervention, including assistance in developing smoke-free policies, nomination of champions, staff training and educational client and service resources, and free nicotine replacement therapy in order to integrate smoking cessation support as part of usual client care. If effective, the organisational change intervention has clear potential for implementation as part of the standard care in drug and alcohol treatment centres. Australian and New Zealand Clinical Trials Registry, ACTRN12615000204549 . Registered on 3 March 2015.
Zbikowski, Susan M; Jack, Lisa M; McClure, Jennifer B; Deprey, Mona; Javitz, Harold S; McAfee, Timothy A; Catz, Sheryl L; Richards, Julie; Bush, Terry; Swan, Gary E
Phone counseling has become standard for behavioral smoking cessation treatment. Newer options include Web and integrated phone-Web treatment. No prior research, to our knowledge, has systematically compared the effectiveness of these three treatment modalities in a randomized trial. Understanding how utilization varies by mode, the impact of utilization on outcomes, and predictors of utilization across each mode could lead to improved treatments. One thousand two hundred and two participants were randomized to phone, Web, or combined phone-Web cessation treatment. Services varied by modality and were tracked using automated systems. All participants received 12 weeks of varenicline, printed guides, an orientation call, and access to a phone supportline. Self-report data were collected at baseline and 6-month follow-up. Overall, participants utilized phone services more often than the Web-based services. Among treatment groups with Web access, a significant proportion logged in only once (37% phone-Web, 41% Web), and those in the phone-Web group logged in less often than those in the Web group (mean = 2.4 vs. 3.7, p = .0001). Use of the phone also was correlated with increased use of the Web. In multivariate analyses, greater use of the phone- or Web-based services was associated with higher cessation rates. Finally, older age and the belief that certain treatments could improve success were consistent predictors of greater utilization across groups. Other predictors varied by treatment group. Opportunities for enhancing treatment utilization exist, particularly for Web-based programs. Increasing utilization more broadly could result in better overall treatment effectiveness for all intervention modalities.
Full Text Available Background: Meeting service quality standards and striving for loyalty are two critical areas which have until now been overlooked by both the passenger transport industry and academia in Pakistan therefore the study sheds useful light on an issue hitherto untouched. Therefore increased sample size will help in increasing generalizability of study. Methods: This paper is designed to study the level of loyalty at Daewoo Express Bus Service in Sargodha by measuring customer satisfaction. Researchers used a small sample of only 96 respondents (passengers and only studies customer's behavior in the service quality of Daewoo Express Bus Service however it may differ in other passenger transport services. Results and conclusions: This paper reveals that there is a positive and significant relationship between loyalty (dependant variable and price perceptions, reliability, retrieving and smoothing (independent variables. However, the study found that reliability of services is the most important dimension among other independent variables (price perceptions, smoothing, reliability, retrieving effecting customers loyalty at Daewoo Express. Paper under consideration would surely assist Daewoo`s management team to take care of the loopholes existing in the current service level and likely threats which Daewoo might face.
Lydié, Nathalie; de Barbeyrac, Bertille; Bluzat, Lucile; Le Roy, Chloé; Kersaudy-Rahib, Delphine
In recent years, the internet has widely facilitated Chlamydia trachomatis home-sampling. In France (2012), the Chlamyweb Study evaluated an intervention (Chlamyweb) involving home-based self-sampling via the internet. One element of the study consisted of a randomised controlled trial (RCT), which is reported in detail elsewhere. The focus of this paper, however, is on describing the Chlamyweb Intervention and reporting on the non-RCT element of the evaluation of that intervention by the Chlamyweb Study. This involves (1) describing the design and roll-out of the Chlamyweb Intervention, (2) comparing the socio-behavioural profiles of the participants in the intervention with a nationally representative general population sample and (3) examining the factors that influence the acceptance and return of a self-sampling kit supplied to participants in the course of the intervention. Self-sampling kits were offered to sexually active people aged 18-24 years living on the mainland French. Participants' characteristics were compared with the general population to describe recruited and participant populations. Multivariate analyses by conditional logistic regression were performed to determine factors that were predictors of kit acceptation and use.